A
how many days does it take for the member to initiate disenrollment?
7 Business days
Name any 1 reward which is not added by member service
Housecalls
What are the things from where the member can activate his Ucard?
1) IVR
2) Website
3) Calling Customer Service
4) One more we do not remember
what are the actions that we take for a medicine to get delivered to the member
We do not handle we transfer it to optum
Authorized representatives or Medicare partners have unlimited authority to make specific changes to the member's account or act on behalf of the member.
False
what type of status do we see of the medicine whether they are covered or not
Formulary
non-formulary
Excluded
True or false
Can the member take benefits from the federal government directly?
True
How do we understand whether the member is registered to our portal or on the website
By seeing the member portal icon on the left on maestro if its blue or not
What are the possibility that we can update the address off the member?
1) Temp add
2) Permanent (county has to be the same)
3) Mailing
If zip code is gonna be the same, we can update
If zip code has to be changed
condition: check with social security if they could update the address
else: get them connected to the
Part A
Part B
Part C
part D
(We were too bored to write hence please explain too)
How many days of screening is required for SDOH?
365 days
What is the procedure If the member states that he is looking for the status of the Ucard request?
Check Member Materials intent if new Ucard request has been generated
True or False
The D-SNP member see whether they have deductible or copay or co-insurance
False
After launching the Member Materials intent, which 'Request Type' needs to be selected from the drop-down to send a Ucard?
PerformMaterialsFulfillment
Name any 3 who are considered as an 'Internal Caller' as per HIPAA guidelines?
New York State Attorney
Customer Service Supervisors
Erickson Advantage Member Services Representatives
Optum Nurses
Explain the steps in brief to search for dental benefits?
Review Medical Benefits > None (check box) > Benefits (button) > Search 'dental' > Check the opened dental service >
Save button > Click on the drop down > yes > yes > LAUNCH Button
To complete HIPAA verification, we must verify the First & Last Name, Member ID & ________ ?
Date of Birth
True or False
Does the federal government pays UHC to help the member ?
True
(Yeah yeah we know out of syllabus question but we are just checking your GK)
Name any 4 SDOH help that the member gets?
(Try your luck if you can get any 4 from the list you will get full points)
Medical Care
Internet
Basic living Essentials
Phone
(if possible a husband/wife too)
Name Any 3 NBA?
(Try your luck if you can get any 4 from the list you will get full points)
Flu shot
paperless
ANOC
How many days does it take for the U card to delivered?
Upto 14 Business days
what is the difference between house call and annual wellness visit?
House calls:
> Once a year
> Entire checkup
> Licensed nurse visits house
Annual Wellness Visit:
> Once a year
> Member visits to the PCP
> Entire checkup
How many overrides are allowed to the member if the medicine is rejected ?
1 (one,Uno,EK)
What is the eligibility and one requirement to avail Medicare services?
The member should be a us citizen residing in the country for more than 5 years and one requirement (65+ or disability)
Which Provider Network does the member use for dental?
National Dual Complete Network