Investigation Process
This step involves gathering information and evidence related to a grievance.
What is an investigation?
This department is responsible for deciding whether a member qualifies for a new shipment of meals.
What is MCO?)
This request involves transferring funds from one expired wallet to another active one.
What is a rollover request?
This final step in the grievance process involves reaching an agreement or solution.
What is resolution?
This technique involves placing an order for a member that does not appear in the order history.
What is a manual order?
This type of check is issued to repay an employee for expenses they have incurred.
What is a reimbursement check?
This term refers to the maximum amount of time allowed to resolve a grievance.
What is the SLA timeframe?
This term describes an order placed for a member that does not appear in the system’s order history.
What is a Ghost Order?
This is the maximum period a BCBSRI member has to submit a reimbursement request.
What is a year?
This software is used to monitor and manage all received grievances and their resolutions.
What is Zendesk?
This term refers to the return of money to a customer for a product or service that was unsatisfactory or not delivered.
What is a refund?
This term refers to a temporary hold placed on funds to ensure payment for a future transaction.
What is a pre-authorization hold?
This role is responsible for managing and resolving grievances within an organization.
Who is a grievance Specialist?
This term describes a shipment that is guaranteed to be delivered by the next day.
What is an overnight package?
This internal process from Elevance Health involves working directly with the NationsBenefits IT Team on rollover requests.
What is the Elevance rollover process?