Medicare Overview
What You Hear From The Member, Active Listening
Handling Calls with Compassion, Sensitivity & Positive Engagement
HIPAA, MiiM & Fulfillment
Member Material Wizard, VCCD, Auth Rep.& CTM
100
Plans generally known as hospital insurance and helps cover medically necessary services including doctors.
What is Original medicare or plans A & B
100
Attentiveness, Empathy, Objectivity, Patience
What is Active Listening Skills
100
Acknowledging the caller's frustration
What is "The Agent answers the callers questions, caller becomes very angry. Caller tells Agent that UHC don't care about our members and we are making insurance way too complicated.
100
Displays your Work Queue
What is The Work List Tab
100
Retrieve, Redirect, Answer, AUX, Ready, Hold, ACW, Release
What is VCCD Tool Icon
200
Includes Part A and Part B
What is Part C
200
Can you tell me the date on the letter you received,? What's the name of the pharmacy where your prescription was rejected?
What is asking purposeful, effective questions at the right level to uncover information while putting the member at ease.
200
Speak with a lower pitched voice, turn up volume on the phone.
What is Caller having trouble hearing
200
General, Plan, Member, Billing, Enrollment, Application, Pharmacy
What is Select Action Category Area of the MIIM 360 View
200
A complaint reported directly to Medicare that is then assisgned to the plan.
What is a CTM
300
People age 65 and older, people of all ages with End Stage Renal Disease (ESRD) and people with certain disabilities.
What is "Who is eligible for Medicare"
300
Active listeners focus on demonstrating four key qualities that help them achieve a constructive, collaborative two-way conversation. They practice Our United Culture Concept - Be Here Now as they seek to understand
What is Qualities of Active Listeners
300
Use positive language to advance the conversation forward, display active listening by asking what kind of issues she is having, apologize for the inconvenience with any issues caller is having
What is Positive Engagement
300
Enter the first 3 characters of the name plus the Wildcard (%) symbol.
What is When Member don't have their Member ID and agent is having a hard time understanding his last name.
300
Member Material Wizard in mySME
What is Whenever you send fulfillment materials to members, use this wizard to ensure you follow the correct steps everytime.
400
May help pay the cost not covered by Original Medicare, but not for prescription drugs.
What is Medigap
400
If you're looking to gain additional insight from the member, open-ended questions are apowerful tool that can turn an otherwise short yes-or-no response into an invitation to share further details
What is Open Versus Closed
400
We need to walk in the shoes of the people we serve and those with whom we work. Sensitivity is the awareness of the needs and emotions of others. Making assumptions is not walkingin their shoes or being aware of their needs.
What is the definition of compassion and sensitivity
400
The Radio Button next to Member ID
What is Search Results, select the correct member.
400
Member Claims Information, Member Enrollment Information, Member Medical Information.
What is Information you can discuss about a Member with an Authorized Representative
500
Deductible, Initial Coverage, Coverage Gap, Catastrophic
What is the four coverage levels
500
Take time and do not interrupt
What is Patience
500
One of the five Core Values of United Health Group.
What is Compassion
500
The Fulfillment Tab in Account Summary
What is The Section that Allows you to see the Fulfillment Type(ID Card), Status (Processed, Pending, etc.), Vendor Status (Shipped), and Vendor Process Date. The Summary Tab only shows the 5 most recent requested items.
500
A diagnosis code that indicates substance abuse, Specifics of a procedure that would indicate a diabetes diagnosis, the details of a claim for inpatients chemical dependency treatment.
What is These are considered Sensitive Information and cannot be discussed with Authorized Representatives.
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