Processes & Handling
What MAX code do you use when you need to follow up with a member via a phone call.
Outbound Calling
Who is our GroupSource Privacy Officer?
Bree Beaulne
This will get you a 0 score on an evaluation.
Not leaving notes, Unproductive idling, Incorrect Transfer or Ending of a contact, Not Transferring a Canoe Member to Canoe Skill. Not properly authenticating.
GHFOC
Group Heath Family of Companies
This word is forbidden on the Malarkey Chat.
Sandwich
(Take that Heather, I just made everyone say "Sandwich")
A member emails us with their new address. What department would we direct this to for the update?
BA - Billing Administrator
Who can request changes to profile information?
Primary Policy Holder
We add this to the subject line when an email chain is authenticated.
The Certficiate.
LWSA
Lifestyle Wellness Spending Account
This new CCR can lift 3 times their own bodyweight.
Laure-Anne Lenzi
How should we be requesting documents or information from member or providers?
Email the member or provider requesting documents with detailed context so the next agent can handle effectively.
On this system a member is required to add their own Authorized contacts.
MPACS
This should be included at the end of any call, chat or email.
An offer for further assistance.
OPR
Official Prescription Receipt
This new CCR wanted to be a sound engineer when they grew up.
Cody Hilstad
We should be doing this whenever possible when a member calls us about Direct Billing Issues.
Calling the provider to Troubleshoot
For providing disclosure on this system, we need to provide a Privacy Disclosure Form
ClaimSecure
When placing a caller on hold, it should be for no longer than _____ at a time.
3 minutes
SDCF
Standard Dental Claim Form
This new CCR swings Fire Poi.
Charles (Chuck) Coutts
When a member calls about a drug. What is the first step to ensure proper handling?
Check the Drug in Coverage Query to see if it's a Special Authorization Drug, or a Coverage Navigation Drug
This is the only thing we can provide to a Parent or Guardian who is not on the policy.
Confirmation if a claim has been assessed or not.
We need this many point of authentication to proceed with a call, chat or email.
Three (But we prefer 4 if we can get them)
Certificate, Policy Holder Name, Policy Holder Date of Birth, Address with Postal Code, Phone Number on File. Email on File.
RAMQ
Régie de l’assurance maladie Quebec
(Regulation of Health Insurance Quebec)
This new CCR has a very poor sense of direction, and can get lost easily.
Sarra El Bouyadi