Call Miner
1 minute
What "script" is used when we self direct?
Consultative Talking Points
How much points is "Compass Processing" worth?
12 points
Finished incomplete screen means?
Moving forward, you will ONLY mark calls as ‘Accepted Case’ if you completed a full screen start to finish.
What is needed to pass PHI/HIPAA? How many minutes do you have to say it?
Parent's first and last name/member's name, DOB and full mailing address - child
First and last name, DOB, mailing address - adult
2 minutes!
What are the 2 phrases needed to achieve a 100% in the SOS Third Party Contact section?
"Third party" and "Friend or Family Member"
Whom can we offer the 1696 to?
All adult cases (except CHMP cases), pending child and adult claims
Call/Case note must specifically state whether the case is being?
Accepted or self-directed and the reason why
Closed Consultative means?
You completed a screen, self-directed, consultative talking points were given.
Which Health Plan currently warm transfers from HP rep to opt-in if we don't have the opt in form?
FCNY
Do not speak Enlgish
What does UHVA Medical Complexity mean?
This is a reminder that we should be completing a medical complexity screening for United HealthCare Virginia (UHVA). The attached excel spreadsheet outlines the questions that we would be required to ask when the flag on the account prompts us to complete(this will be red in the upper left hand corner just like pending apps).
"Enough Info" At a minimum, the following must be gathered for adults?
Adults: 2 ADLs, 1 limitation, 1 symptom with frequency, treatment source info
Not Interested means?
Member not interested at this time BUT agrees to future follow-up.
All Federal tax refunds and advanced tax credits received are not counted for how many months?
12 Months
What are 2 different phrases for SOS Ownership?
What is the max hold time to put someone on hold?
2 minutes
Enough Info - At a minimum, the following must be gathered for children cases?
1 symptom with frequency, 1 limitation, Milestones/GABS, and treatment source info
Call Attempted means?
Left voicemail / Dead air / No answer / Call Disconnected
We accept most HP Member pending cases. What pending cases do we not accept?
ALJ Pending Cases
What is our team's Call Miner Scores Month to Date 3/1/2023-3/24/2023?
Team is: 96.56!
What are the 2 reasons why the SOS of the rewire error would have to work their own error?
Job error and Identification such as incorrect name/spelling, DOB, or SS#
All "blank" must be listed with name, prescribing doctor, and reason
Medications
What is a passing score of Call Miner?
92%
What is the current weekly incentive?
PHI, FCC, Politeness and last but not least…
Third party!