Errors
How many points does the agent lose for each typographical error?
1 point for the category
If you are auditing a United Healthcare choice plan what should the agent have asked for on the call?
Employer carve out and supervisor
If an agent has a pharmacy case which notes should they use?
PBM template
on the credentialing form how many questions can the agent miss before they fail?
1
What is the suite number at Emerson?
1515
Which category should you mark if the agent forgets to attach the PA form?
Agents should not be attaching PA form
How should the coverage look on a Medicare QMB plan?
20%, 183 DED on 1st VOB and 0% with no DED on second VOB
If the patient does not have AOB benefits how should the notes read?
AOB is not available
When listening to a call which codes must the agent state?
Admin, J code and Dx code
How many cases are you expected to complete per day?
there is no set number depends on volume
When listening to a call before the VOB is sent if the agent does not escalate to a supervisor accordingly which category do we mark that in?
We do not listen to calls before the VOB is released
Why can't Medicare ever be secondary to commercial?
It can
If we do not call on a IBC plan how should the agent fill out the ebif?
By using the AR19 blurbs tab
Send an email with how much time they have left
When are AR cases expected to pull over in to CareCentral?
December 22
If an error is identified by a QC agent on the second audit that was not on the first audit what should they do?
Mark the error in the comments but do not mark another error
What is the percentage in the catastrophic stage of Medicare part D (assuming no LICS or Enhancement)
5%
If an agent does not use the ebif should they always be penalized?
No they can use the PBM template
What is the max number of agents a QC person can credential in one day?
As many as they can
What day on our calendar is marked as a review day?
October 31
If we get a returned VOB how do we identify a way to handle that?
Listen to the call and look over the VOB and notes
What are the coverages for PBB, AOB, and SPP for Medicare with a Supplement plan F?
PBB 20% 183 DED covered by sup
AOB None
SPP None
If we receive a missing information case how should the notes read?
We should not receive these
How many total parameters are on the call script side?
25
How many Carecentral power points are currently in the G drive?
3