Name that SOP
Which sop do you use for member complaints?
What is the Appeals and Complaints Advocacy?
System used to search a member's policy
What is ISET?
You must ask a member these questions if they are calling in about someone else on the policy over the age of 13.
What is Name, DOB, Do they have permission to speak on their behalf
How many rules of COB are there
What is 7?
We should ignore triggers that pop up on a member's policy.
What is False?
You can find the preventive care guidelines in this sop
What is the Benefits and Coverage Advocacy?
System used to look up the members benefits?
What is Ava or Ibagg?
An insurance agent is calling in to verify eligibility information for a member. What verification questions will you ask
What is
Caller's name
Organization name and contact number
Member id/SSN of member, first and last name dob, and address
Permission to speak on members behalf
What provider speciality does a member need for foot care?
What is a podatrist?
We can update a member's Coordination of Benefits in ISET and CDB
What is True
Which sop do you use for Coordination of benefits updates?
What is the Eligibility Advocacy?
System used to check for programs available to the member
What is the Dashboard?
Information is loaded into ISET/ACET, and the caller is calling about themselves. What verification steps would you take?
What is Confirm/Verify first name
If a member needs a replacement id card, and can not wait to receive it via mail where can you refer the member?
What is myuhc.com
We can use Knowlege Library to look up the description of procedure/cpt codes
What is true?
I can help guide you if the member needs help with navigating myuhc.com
What is the Self-Service Advocacy?
What is the name of the form that Form allows an individual to grant permission for UnitedHealthcare to mail or discuss a member's PHI to a specified individual.
What is the Authorization to disclose form
What is the name of the resource that houses the sops?
What is the E&I Toolkit?
When Quoting Benefits we do not quote the limits and exceptions.
What is False?
Which sop would you use for guidance if you needed to send the member a compassion card
What is the Building Trust Through Advocacy SOP?
System used when discussing financial accounts that we have access to
What is CAMS?
What information will you need to verify if you have to call a member back?
What is last name, dob, and address
In which advocacy can we find the DME code list?
What is the Benefits and Coverage Advocacy?
The documentation/notes on an account is called an ORS
What is true?