3rd Party/Informal Representative
The icon where you would verify if caller is POA/ AOR in PS
What is padlock
The way we should always transfer our calls
What is WARM transfers
The greeting all CCA's say
what is Thank you for calling. My name is...
The system we use to file grievances
What is compass
The 4 Medicare Part D Phases
Deductible, ICL, GAP(includes Troop), Catastrophic
The information you need from 3rd party/informal Representative
What is, caller's First and Last Name and all 4 authenticators
The amount of minutes we should leave the caller on hold before touching base with them
What is 2 minutes
The information we need when call is IVR authenticated
What is member's First and Last name
The Primary Interaction Reason we should always select in Compass for a grievance pertaining MOR?
What is Order Management
The percentage member is responsible during Donut Hole/GAp
What is 25% of medication cost.
The question you ask after authenticating 3rd part caller if you don't know mbr's availability
What is, "Is <member's name> available for me to speak with"
The action CCA should take before warm transferring to receiving party
What is authenticate the member/caller
The 4 authenticators
What is Full Name, DOB, ID number & Zip Code
The member is out of medication and it was due to pharmacy error
What is Quality of Care
The limit amount ($) before a member reaches the GAP coverage
What is $5030
The action you take when a different person comes on the phone to inquire about the account
What is re-authenticating account will all 4 authenticators and asking PHI question.
The action CCA should take when call has been transferred to receiving party
What is introduce member/caller to receiving party
The information we ask if member can't provide CCA with ID number
What is RX name, RX number, Medicare #(HICN/MBI).
The medication is too expensive for the member because of the tier (One Day or Standard)
What is Standard
The step(s) member should take to fall out the GAP coverage
What is when member spends a total of $8,000 out-of-pocket (this does not include any payments made by the plan) if Troop is not met member will wait until following year
The information you provide to 3rd party caller when mbr's NOT available to speak with you
What is, only provide information that can be found in CIF(general benefit information). IF caller provide you with name of medication we can verify drug coverage but no changes to the account can be made
The action CCA should take after transferring member/caller
What is disconnect from the line and let receiving party close the call
The value statement
What is Thank you for being a valued member
The emotion we should always demonstrate when member is dissatisfied
What is Empathy/ Apology
The members who are not subject to the GAP phase
What is Members eligible for low-income subsidy