what is the difference between the training and production version of CRM service?
CRM Training Region
Training version contains a blue header, Accessed under HSS Learning, Used ONLY during instructor led training.
CRM Production (live) Environment
Production version does not contain a header, Accessed via DIG toolbar or under HSS Service Operations, Used ONLY when handling live calls.
Do we handle IDs that start with an H?
No, we must transfer them to Humana
Can we look up a member by their social security number?
No, advocates are not permittes under any circumstances (per CMS regulations) to ask members for their SSN
What tab is used to search members that are not found on the Member Search tab?
Enrollment Search
How can we custom DIG?
To customize the color, clicking the computer icon.
What are the two ways we can acces to CRM?
We can access via the DIG toolbar, MyApps or on the drop down menu for "systems" found on Sharepoint.
Where can a member look up for the Careplus ID?
On their Careplus ID Card
What are the required fields on the Unknow Account page?
First Name, Last Name, and Home State/Province.
Who are the Agents and brokers?
Agents and brokers are licensed sales representatives who evaluate a member's needs and assist with enrolling them in a plan to best meet those needs
For what can we use DIG Toolbar for?
We can use this toolbar to quickly navigate to the other systems. DIG was designed to shorten the workstation startup process, improve productivity, and significantly reduce average call handle time.
How CRM Lightning Help advocates during taking calls?
CRM Lightning acts as a one-stop shop for all things member related. It helps advocates find information easily and quickly
How many applications are accesible from CRM Lightning?
there are over fifteen integrated applications accessible from CRM Lightning
How can we search a provider?
Tax Identification Numbers (TIN's) and the National Provider Identifier (NPI) number
Which tab uses Member ID, name, or birthdate as the search criteria?
Member Search
What is the main system you will use in handling calls, which you should keep open on a dedicated monitor?
CRM Service
What means CRM?
The Customer Relationship Management (CRM)
What application do we use every day on every call?
Softphone application
What are the different search Methods?
Member
Provider
Agency/broker
Enrollment
Global Case searches are done using ____ if only a partial number is available
Asterisk
What is the name of the icon on Launchpad where we can locate the DIG Toolbar?
Via the Go2 Dig BOT
Contains links to Hot Topic Mentor documents and HIPAA job aid
Additional Resources
Account information displays in CRM Service once an ________.
Interaction is created via the Interacting With & About, Interacting With, or Interacting About button(s) on the applicable Search tab.
Can an advocate accept the SSN voluntarily offered by the caller?
Advocates can accept SSN's if voluntarily offered by the caller therefore, pose the question as such, "Is there any other number I may be able to use to look up your information?" When able to obtain a member’s SSN without directly asking for it, select the Automated Enrollment (AE) History radio button on the Search Enrollment tab to search within that system.
We would verify demographics information to confirm we have accurate information on file because we view an alert which means
The member’s address has not been verified in the last 90 days or more