Application
What page of the application shows the applicant's personal information such as their name, date of birth, etc? Where in UWS would you go to update this information?
Page 1 of app, Applicant Information tab in UWS
What is a full health interview?
Asking every health question on the application, verifying medications and asking additional script questions if applicable.
Memory is a valid diagnosis.
True
True or False: Tachycardia is a heart condition
True
The applicant calls and requests to withdraw the application. What would be your handling steps?
If at any time an applicant or the producer of record requests the application be withdrawn- The
interviewer should open a non-visible - “Interview complete task” in UWS with no HFR date. Note in
the task who you spoke to and the request to withdraw the app. Close all other tasks.
a. If the applicant requests to withdraw during an interview you will need to save and submit the
interview, and then open the task as detailed above. Include in your task that the interview notes
were submitted as is and are not fully complete.
2. Forward the case to the Decision Queue as outlined above.
3. This does not apply to cases that are already issued or are app issue in progress. Please follow the
steps in the Dispositioned Cases Document for these situation
The applicant answered the Medicaid question yes. What would be the underwriter's next steps?
Verify the Medicaid benefits the customer receives.
True or False? You should ONLY ask the questions that are included on the interview template by the scrubber; even if the customer provides additional information that coincides with a health condition that we underwrite for.
False, you should pay attention to the health conditions, procedures, etc. that the applicant states during the interview as they may lead to additional questions that the scrubber had no indication of asking on the original template.
Arthritis is a valid diagnosis.
False-we must know the type of arthritis.
True or False: Osteoporosis is inflammation of one or more joints, causing stiffness that can worsen with age.
False, that is Osteoarthritis. Osteoporosis is a medical condition in which the bones become brittle and fragile from loss of tissue.
This means that if the applicant wants to change their plan type, a voice amendment would be required. As we only do voice amendments on cases that we issue and you are not trained on this process, we would simply ignore that note for now.
When the customer answers you notice they do not speak English. There is not a Non-English speaking form in the file. What are your next steps?
Disconnect the call from the customer and forward the case back to the original underwriter, explaining that a Non-English speaking form is required before completing the interview.
True or False? The phone interview may be completed with an adult child as long as we have verbal permission from the customer.
False. We cannot complete a phone interview with an adult child regardless.
Thyroid
If the applicant has an implanted cardiac defibrillator or pacemaker, what questions should we ask?
Heart
You receive a case back to your que that has an "Additional Call Needed" task and states we need a dx code for Coreg. True or False: you may contact the client's doctor and request the diagnosis code for them.
False- the client must contact their doctor and obtain the diagnosis code for Coreg. If the client is upset about this do your best to de-escalate the call by stating "I do apologize for the inconvenience, but in order to continue processing your application and make a decision we must have you obtain this information. Due to HIPAA privacy laws, I am unable to obtain this information for you".
The Medicare Card number is located where on the application? Where would you go in UWS to update this information?
Page 2 Section C on app, UWS Medicare and Guarantee Issue information Tab
True or False? The phone interview may be completed with a POA as long as we have verbal permission from the customer.
False, the phone interview must only be completed with the customer unless given permission to speak with their spouse or significant other.
If an applicant states they are taking Warfarin as needed for "Thinning the blood" What would be your next steps?
How often is as needed? What condition causes you to need a blood thinner? Ask appropriate health questions (Stroke, heart, PVD, etc)
The applicant states they have an upcoming mammogram. Should the underwriter ask additional questions?
Yes, is it routine or for cancer?
Mrs. Smith calls in to do a voice amendment and you notice she is hard of hearing and she is unable to fully understand you completing the voice amendment script. What would be your next steps?
If the client is unable to hear you well enough to do the voice amendment kindly advise the customer you will be in touch with their producer in order to obtain the corrections as this is a legal document that must be understood by the client.
Where can you find what the applicant's authorized premium amount is?
BSP Auth PDF or Payment Information tab in View/Edit in UWS
If an applicant indicates they stopped taking a medication what would be your next steps?
Ask when it was stopped and why? Did they stop on their own, or did their doctor recommend it? Was it replaced with another medication? If so, what was the medication and how long have they been taking it?
The applicant states she is taking Hydrocodone as needed for pain. What would be your next steps?
How often is as needed? What type of arthritis? Arth/DBD questions.
During the interview the applicant reveals they had a blood clot in their leg 20 years ago. What if any, questions should be asked?
PAD/PVDT
You receive a phone call and the client states they were told to obtain their medical records and request that instead you contact their doctor and request them. What would be your response?
Explain you are unable to request their medical records and all records requested would be at the applicant's expense.