Privacy and Disclaimers
Required pieces of disclosure for Medicare.
What is Medicare number or SSN or both?
The reason to utilize scripting on each call interaction.
What is to provide accurate information?
This happens on each call interaction.
What is opening a contact record?
state Medicare or CHIP agency representative, Marketplace Appeals Center representative, navigator, in-person assister, certified application counselor, agent, broker or tax preparer.
What is third-party callers?
Name and 2 additional pieces of information, such as your Social Security number, address, date of birth, or application ID?
What is passing disclosure in Marketplace?
True or False - If a caller does not pass disclosure, you can release account and enrollment information to the caller.
What is False?
Consumer wants to end coverage for 5/31/2025, CSR accidentally ends coverage for 6/30/2025. This will cause a...
What is a hardship?
After reading the appropriate script to the caller, you do this next.
What is logging scripting?
Use this script to help the consumer end coverage for everyone on the application.
What is Ending Marketplace Coverage for All Applicants?
If the consumer is staying on the line for the current call, use this option.
What is verbal permission?
The date and month of birth must exactly match, but the birth year provided can be within...
What is 2 years of the birth year listed on file?
You can't order a replacement Medicare card if the date in the field is less than this amount of days from the current date.
What is 30 days?
After passing disclosure, you do this for each piece of information.
What is checking the disclosure boxes?
Always use this script after the consumer enrolls in a Marketplace plan to prevent callbacks and escalations.
What is Enrollment Closing Language?
If the consumer wants to leave the call, you need this to continue speaking with the person who remains on the line.
What is verbal authorization?
Verbal warning, written warning, separation.
What is the corrective action process for privacy and disclaimers?
This is the amount of days you have to appeal a denied claim.
What is 120 calendar days?
This has to be read to the consumer any time you see this consumer indicator.
What is consumer messages?
Use this script only after you have verified that the beneficiary does not receive low-income assistance but wants to know more about the types of assistance available and how to apply.
What is Applying for Low-Income Assistance?
When you place a caller on hold to reach out to ISG or to set up dead air throughout the call.
What is managing non interaction time?
1-800-MEDICARE
Written Authorization Dept.
PO Box 1270
Lawrence, KS 66044
What is the address to send written requests to revoke or remove authorizations?
Formal warning, verbal warning, written warning and separation.
What is the corrective action process for Information Accuracy?
When a caller does not have an account in the system you go here to open a contact record.
What is the Contact screen?
You suspect suspicious or fraudulent behavior by an agent or broker.
What is Suspected Fraud by Agent or Broker?
First 3 scripts you should log at the beginning of every Marketplace call.
What is Welcome script, State script and Authorization and Disclosure?