Random
Where is the group AKA list found?
SmartSheet - linked on the care management home page
What compass direction is assigned to these cases?
South
What compass direction is assigned to these cases?
North
What is the passing score for QA?
93%
Who answers incoming calls from members and providers?
CSR or Intake
What is the Personify logo/mascot's name?
Percy
Where are plan benefits found?
SharePoint
Where are plan benefits found?
TPA Advantage
When does the case summary need to be updated?
The last 5 business days of the month
Which department reviews precertifications?
UR - utilization review
Did you submit a success story in January?
Yes
Regular or special mailings?
Regular
Regular or special mailings?
Regular (except for Mountain Health Coop)
Stop loss (increasing the AC amount and tasking triage for groups that have SL)
Which department creates cases to upload to the dashboard?
Triage
Have you ever submitted a Kudos for a colleague?
If not, consider doing that :)
Where do we find RX info/reports?
Who do we contact for provider push back or finding IN facilities?
RBP concierge team
Do we need change the diagnosis on the case summary page?
Yes - often we should
Which department handles internal SCAs?
Payment Integrity
Can you pronounce my last name?
Nobody can - free points!
How do we get contact info for these MMs?
Task Leah Johnson
How do you find out who is the claims supervisor for a BAS group?
In TPA advantage > account hyperlink > account tab
Which groups should we request the Benefit Focus report on and how often?
BAS groups (and select HC groups listed on the SOP), request quarterly.
What is the name of our high risk maternity team?
Nurturing Together