Misc.
Where on the application can someone enter their "Safe At Home" address and Participant ID?
Under Section 1- Primary Contact.
What do we do when an agent gets a call from a family friend?
If if an agent receives a call from a friend or family member, they must notify a supervisor or lead and transfer the caller to another agent.
What are the types of MI that must be submitted in writing? Please name them all.
-Signature of parent/guardian/emancipated minor
-Proof of Income
-Referral/Prescription from health care provider for hearing aids services
-Other Health Care Denial Letter/Summary of Benefits
-Insurance card with child's name
Caller wants the school counselor to have access to their case. What would you tell this caller?
You can authorize someone else to get case specific information, but only on a per call basis. You will need to provide verbal authorization each time they call in.
What are the acceptable file types an applicant can use to upload a document through MedChat? What is the maximum file size?
All file types are accepted and not limited to JPG, PNG, BMP, Word, GIF, PDF etc. The max file upload is 30 MB. Only 1 upload opportunity, per session can be uploaded at a time.
How do we "exhaust" a person search?
Make sure to uncheck the ‘Exact Match’ box.
The working search fields available are: ‘Last Name’, ‘First Name’, ‘DOB’, ‘CIN’ and ‘Person ID’.
- Search by child or spouse's first and last name.
What 4 pieces of information need to be added to your notes after a call?
What 3 actions taken should you include?
a. Who is calling
b. What the caller needs (what triggered them to call)
c. (When applicable) dates of service, date something was faxed/mailed
d. What are your actions taken
i. Referrals
ii. Processing timeframes
iii. Include the WQ information when applicable
How many PD calls do we make when an applicant has MI?
If a MI determination is made, PD will attempt to call the applicant up to 5 times.
What is the difference between PED and PAVE?
The Provider Application and Validation for Enrollment (PAVE) portal is the Provider Enrollment Division's (PED) web-based application designed to simplify and accelerate enrollment processes.
(PP #92)
How can a chatter uploads documents during a live-chat session?
To attach documents during a chat session, direct the chatter to upload by clicking on the paper clip in the lower left had of the chat bar.
What is another term for an applicant who has a primary health insurance, along with our program?
When someone is active with two insurances at once, this is called Dual Coverage.
Whose income counts when eligibility is determining a household's income?
i. Spouse for Spouse
ii. Parent for Child
iii. Self for Self
What is in an AER packet?
When is this packet sent out?
Each year, the applicant will be asked to confirm the child/subscriber’s qualifications for HACCP. In order to continue with HACCP coverage during the AER process, the Subscriber must meet all the eligibility requirements as listed in the “Eligibility Criteria” section of WI. The applicant will be sent a “Notice to Continue Coverage” with a HACCP Application attached 60 calendar days prior to the subscriber’s anniversary date.
What is on HACCP's Program Identification Card?
Please list all items.
1. First and Last Name
2. Date of Birth
3. CIN
4. Issue Date
Please state the steps to tag an FMN.
To send the chat information with FMN to MAXe2 click “/” and select ‘Add a tag.’ Enter FMN in the ‘search tag or add custom’ then hit ‘Enter’.
What do we need to submit in Maxe2 if a non-conformity is found, and how do we go about this process?
HACCP Leadership (Supervisor & Team Leads) will review the case.
Urgent WQs will be sent to HACCP CC Consolidated and includes the following detail:
i. Type out “URGENT” before the short description
ii. A short description of the issue
iii. The date of service
An applicant disagrees with their eligibility determination.
What can they do?
What would they need to fax/mail us?
Bonus Points (20): What is a Program Review? Explain.
Caller may submit an appeal. The appeal must include:
A copy of the letter regarding the decision being disputed, or a written statement as to what is being disputed and how they think the issue should be resolved.
Include any other relevant information. Make sure to have them write their HACCP family member number on the appeal.
What are all of the acceptable income documents if you receive non-self employed wages?
1. Paystubs
2. Federal Tax Return
3. Employer Statement
4. 1099
I lost/misplaced my Program Identification Card. How can I get a new one?
Bonus Point (5): How long does it take?
As the CSR, you will submit an Urgent Work Request and send it to CC Consolidated.
Urgent Work Requests take 2 business days.
How long can a caller be kept waiting or "on hold" in between responses?
MedChat will be treated similarly to an inbound call to its closest interpretations due to the systematic difference. For example, on hold time, we will allow a +1 minute to the 2 minute rule due to the seconds not present in MedChat.
A caller has asked us to mail them 10 applications.
How do we fulfill this request?
If the caller/applicant is requesting multiple applications, submit a WQ and indicate how many applications are being requested (in this scenario, 10) and in what language they would prefer.
In what situation do we add a mailing address in addition to a home address?
A mailing address should only be added to case when the applicant states it is different from the residence address.
Applicant does not qualify for our program because their income was too low.
What happens next?
Provide caller with their county resources (phone number) and explain their application and supporting documents are forwarded to the county of residence.
How does one access the webinars?
To access the webinars, you would need to visit the HACCP website and follow the steps:
Select "Resources" under the "Providers" category on the HACCP page
Scroll down the page until you see ‘Events/Informational Webinars’
Click on 'Events Archive'
Choose corresponding webinar by selecting 'Powerpoint' (most recent webinar is best).
When transferring a chatter due to needing a Spanish-speaking agent, what are 2 important steps?
1. The agent must select a Spanish topic when transferring, so that the Spanish agent has access to the Spanish quick-replies.
2. The chat history must not be transferred.