Errors
Payer Types
Notes
Credentialing part 2
Miscellaneous
100

How many points does the agent lose for each typographical error?

1 point for the category 

100

If you are auditing a United Healthcare choice plan what should the agent have asked for on the call? 

Employer carve out and supervisor

100

If an agent has a pharmacy case which notes should they use?

PBM template

100

on the credentialing form how many questions can the agent miss before they fail?

1

100

What is the suite number at Emerson?

1515

200

Which category should you mark if the agent forgets to attach the PA form?

Agents should not be attaching PA form 

200

How should the coverage look on a Medicare QMB plan?

20%, 183 DED on 1st VOB and 0% with no DED on second VOB

200

If the patient does not have AOB benefits how should the notes read? 

AOB is not available

200

When listening to a call which codes must the agent state?

Admin, J code and Dx code

200

How many cases are you expected to complete per day?

there is no set number depends on volume

300

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

300

Why can't Medicare ever be secondary to commercial?

It can 

300

If we do not call on a IBC plan how should the agent fill out the ebif?

By using the AR19 blurbs tab

300
What do you do after the call portion is done?

Send an email with how much time they have left 

300

When are AR cases expected to pull over in to CareCentral?

December 22

400

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

400

What is the percentage in the catastrophic stage of Medicare part D (assuming no LICS or Enhancement) 

5%

400

If an agent does not use the ebif should they always be penalized?

No they can use the PBM template

400

What is the max number of agents a QC person can credential in one day?

As many as they can

400

What day on our calendar is marked as a review day?

October 31

500

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

500

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

500

If we receive a missing information case how should the notes read?

We should not receive these

500

How many total parameters are on the call script side?

25

500

How many Carecentral power points are currently in the G drive?

3

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