MEMBER CALLS
RING RING! This is Gigi and I'm calling about my benefits...
Which GPS tab will I use?
Member Search
Gigi is requesting Genesis information on her cleaning she got in July 2025. What Level is this?
LEVEL I
What are 3 ways we can search by in the Provider Screen?
Provider ID
Name
Advanced Search
D0274
Bitewings - 4 Films
MM ID - How many dependents are on the plan, not including policy holder?
2
Gigi placed me on hold with no warning, how long should I hold for?
2-3 minutes
Where on my CS Toolbar/Folder can I find Confidentiality Info
CS Toolbar/Folder - e.policies - Confidentiality
On the provider Search screen, after inserting a TIN and selecting the dentist, what info populates?
PV Name, Phone, TIN, NPI, PIN, Address, PV Type and Network Status
D2740
Crown - Porcelain/Ceramic
MM ID - What is the Plan Sponsor Name?
COSTCO
Change Membership/Products
I, the stepmom, need a copy of the EOB for my dependent who is 18 years old. I don't know what they got but I need it.
Level II
Once in the provider screen, where can I find the providers NPI?
Deep Sedation/General Anesthesia
No
The Gramm-Leach-Bliley Act of which year?
1999
Gigi needs new ID Cards and the group does offer it.
Level I
When a provider calls for a dentist, what is NOT required to validate?
Providers date of birth
D7220
Removal of Impacted tooth (DIN) soft tissue
MM ID - What info can be found on the Service Center Information Screen?
Hours of Operation
If Gigi can't provide her DOB, how can I validate?
Full Address
Provide 3 examples of Personally Identifiable Info (PII)
Nested Member Search
D4341
Scaling and Root planing – 4+ teeth per quad
MM ID - What is the Plan Summary?
PV