Can you Verify or Nah
What do you need to verify when there is a full screen pop?
Name, Full Address and Telephone number for the person they are calling for
The consumer does not have a PCP, what is the script that you read?
I will check to find 3 PCPs near you and what health plans they accept
Mrs. Norman called in to change her plan and wants Gesinger Health and does not have a PCP. How do you proceed?
You would add Preferred Plan to your search criteria, and you do not have to offer the other available plans.
Oprah is calling in for sister Gayle. Oprah is not listed on the case. Do we set or link the call and Why?
Call would be Linked because she is not listed on the case under the family members tab.
How many teeth can sharks grow in their lifetime?
50,000
Who can get general information without consent but needs consent to transfers plans?
Caseworkers calling from CAO, Case managers from other DHS agencies, Health Plan Representatives calling from the consumers current plan
Mr. Jones called in and was very upset that he has to change his plan. Mr Jones starts to use abusive language and proceeds with personal insults and repeated use of profanity. How do you handle this call and what should be sad to the caller?
Click on the Fair Warning Instructions and read the script. Provide the 1st warning "I am trying to assist you but if you continue to use abusive language, I will have to disconnect the call and end our conversation. If the consumer does not stop.. End the Call, I have warned you about the abusive language. At this time, I will have to disconnect the call and end our conversation. Good Bye. Notify a supervisor and document the call
Consumer called in to ask what Website they can view plan information on. What is the website you provide them and what do you put in MAXe?
EnrollNow.net. You select General Question Call as the Manual call action and note consumer wanted website to view plan information
What one step is Required to search for a Specialist in MAXe?
Uncheck the PCP box
Approximately How many hairs are on the average human head?
100,000
Jennifer calls in to transfer her plan. Her English is not very well and her 10 year old son is there to translate. Her son is having issues pronouncing some of the words and hands the phone to his coach who is a friend of the family. How do you proceed? Can you speak with the son and/or the coach?
Yes you can speak with both. However you have to ask the interpreter to obtain consent from the consumer.
Dominic Toretto is calling in to change his plan. His enrollment status says Plan Selection Made and he wants to change his plan, but doesn’t want to select a PCP until his wife Letty gets home in 2 weeks. How do you proceed? What are the steps leading up to the SNS survey?
Go to the Plan Selection Made Script, Select Enrolling without a PCP. Click on Search Plans Hyperlink, Search, Offer all Plans, Choose the override reason #2 Chose not to select a PCP, Select Consumer and Process
The consumer wants you to pick the health plan, what is the script you read?
I can give you more information to help you make your choice. All of the health plans provide the same medical services. The difference are doctors and hospitals that choose to participate with the plans. The plans also offer extra services, such as special programs. You can read the Comparison Chart in your packet to learn more about the plans. You can also look at the Consumer Guide, included in your enrollment packet, to find out how other people rate the plans. If you want a complete Consumer Guide, you can visit our website at www.enrollnow.net, the PA Enrollment Services mobile app, or I can send you a copy in the mail.
What is the workaround if you receive an "address is invalid" error message when trying to locate a PCP?
Search for the PCP using the County and Zip Code (if they know which plan you can add that filter also)
When you Chew, does your upper jaw or lower jaw move?
You are only moving your lower jaw
Beyonce calls in for her step niece Green Ivy and she is not on the case. You look in the Family Members tab and the Past Members tab and she is not there. You notice that her name is listed as the "ATTN" person in the address field. Can you speak to her?
Yes, we can speak with the person named in the address field as "Attn" to them.
The consumer prefers a plan that their PCP is not participating with. What do you do and say?
Check to see if a PCP in that practice is participating and then say " There is a PCP in the practice that is participating with the plan that you prefer. Would you like for me to assign this PCP instead?
Ben Afleck calls in and says he does not have his Access ID number and says his SSN very fast. You ask him to repeat it and he says it again even faster. Is it ok if you just tell him what you already have and ask him to repeat the last 2 numbers?
NO! We can not repeat any portion of the SSN and would have to ask the caller to repeat it one more time.
What are the steps to update an address in MAXe?
Select Address Tab, Click Add address, Select Consumer reported mailing address, Add the address and click Submit. Advise the consumer to call CSC
When eating tacos, do you tilt your head or the taco?
BOTH
Bruce is calling in to ask about the new plans. He verifies the correct phone number. He says his address is 2455 Maloof street. But on the file you see 2156 Maloof Street. He insist this address is correct and we are wrong. Can you update the address for Bruce?
Agent must attempt to verify the Old information before updating to the new demographic information and moving with the call.
After attempting to verify the address and phone number, the ES can then update the information and move on with the call as long as the phone number OR address has been correctly verified
You are in the middle of reading the WFS survey script to Ms. Cooper and she says "That is none of your business, I am not answering that" . Do you still have to open the WFS survey, if so what do you select? The consumer then hangs up, What do you do from here?
Yes, you have to open the survey on each call, you would select Chose Not to Answer. If consumer hangs up, you would DISREGARD the transfer and select manual call action and make notes.
What is the correct way to end EVERY CALL? 3 Steps
Is there anything else I can assist you with today?
It was a pleasure speaking with you today. Before you go would you like to participate in a brief Customer Satisfaction Survey?
Thank you again for calling Enrollment Services, Have a nice day.
What must you select AFTER you select the Manual Call action. What must you do after you add notes before selecting Call Done?
Select Add Event and Select Save before selecting Call Done.
What is the only mammal that can NOT jump
Elephant