Subject/Category
A call inquiring about eligibility effective date
Eligibility
Status: other
How many pieces of PHI do we need to authenticate?
Three
Which application in Facets will you open every day before taking calls?
Customer Service
How do we find vision benefits in Benefit Tracker?
View > Vision Benefits
Where do you search for INN Providers?
Find a Provider
A call inquiring about Hospital benefits
Medical Benefits
Hospital
How long is a verbal approval valid?
For a single phone call
Which click notes are selected for eligibility?
Eligible
Effective Date
Plan Description
Class Description
Under which category would you find "Speech Therapy"
Rehabilitation (Outpatient)
Where can you find the member handbook?
Your Resources > General resources > EOCCO Member Handbook
A call inquiring about coverage for a vision exam.
Vision Benefits
Exam
What information can you use to validate a member?
First and Last Name - Required
DOB - Required
Subscriber ID / Address / SSN
A provider is calling, where do you document their NPI or Tax ID?
Under which category would you find "Preventative Mammogram"
Preventative Care
Where can you find information about the Free Ride Program?
Your Resources > Non-emergent medical transportation
MMIS shows our member is active, but Facets does not.
Eligibility
Discrepancy in Eligibility
What should you do when a caller provides their SSN?
Mask the call.
Don't forget to unmask once they are finished.
Where do you check to see when a member was originally eligible?
Transfer > Eligibility Inquiry > Open Customer
Under which category would you find "Wheelchair"
Professional Services, DME, & Supplies
Where can a provider find the sterilization consent form?
I'm a Provider > Resources > Forms > Sterilization Consent
A call where we helped find an INN provider for a member.
Provider
Search: is provider in network / Search: other
Where can you find PHI auth in Facets?
Transfer > Member Authorization
Once a call is completed, how do you close the task?
End Call > Resolve at first contact (if no follow up is needed) > OK
Under which category would you find "Sleep Study"
Diagnostic & Imaging Services (Lab & X-ray)
Where can you find the Provider Manual?
"I'm a Provider" > Resources > Manuals & guidelines > EOCCO provider manual