HIPAA
What is a federal law that protects the privacy of a patient's health information?
"HIPAA" or Health Insurance Portability and Accountability Act
Must be said VERBATIM for legal and vendor requirements within 2 minutes of introduction...
What is "recorded line for quality assurance purposes", or "... for quality assurance"
(Either variation is acceptable)
These are the number of rounds our campaigns have...
What is "OB1, OB2, and OB3" or "three"
This worksheet is used to show who handles inbound calls for the day, SOPs and close reasons are also listed here ...
What is a "queue schedule"
This number is used to check IEB status online and/or on calls
HARMONY ID
An individual we can leave a message to have the member return our call but we cannot speak about the member's case with?
What is a TPC or "Third Party Contact"
This is explained BEFORE making the conference call to IEB, after explaining the 3-step waiver app process
What is "Authorized Rep" consent/ explanation
This "note type" is used when notating a case while in CC
What is "campaign"
We remain in contact but the member refuses or is unable to submit CAO proofs
(close reason)
What is "uncooperative - financial proofs"
Provides instant automated income and employment verifications for CHS
THE WORK NUMBER
The Work Number - Employment Verification (sharepoint.com)
An individual who has POA documentation and/or a member has provided verbal permission during a call to speak to that contact openly.
Who is an AR or "Authorized Representative"
This is the second step discussed in our scripts AFTER the member expresses interest in services
the medical portion of the process...
What is the "FED" or "AAA assessment"
This button (activity) SHOULD NOT be used at all
….until further notice
What is "outreach to member"
We should be handling cases as our own, to the best of our ability, when on the phone with the member or agency …
What is "one-call resolution"
In this clip, what TRAINING topic is Joy discussing?
Hint: Two words, and is a skill that must be present in customer service
What is "phone etiquette"
Centauri requires HIPAA risk assessments to be performed how often?
What is "Annually"
During the screening process, these steps are done if the member DOES NOT want to complete a call with IEB to schedule intake...
1. Explain w/o authorization, we are unable to assist with the process
2. offer a warm transfer to IEB
3. Provide IEB phn# along with our CB#
4. Send CEP
A monthly file received from our vendor, usually around the 20th of the month
What is "UPMC membership file import"
ancillaryservices@centaurihs.com
This is the LTC organizational hierarchy list
1) Jeff Belsito - SVP, Operations
2) Kristie Leavell- Director, Proj Management
3) Yvonne Mysore- Team Lead
The Privacy Regulation addresses electronic and paper health care information, while the Security regulation addresses patient rights to information.
What is "false"
This phrase should NOT be said when leaving a voicemail due to privacy practices...
Hint: updated recently in scripting
What is " CHC" or "Community Health Choices"
The "expected" number of prioritized members sent to LTC every month for outreach
What is 750
This usually will prompt a call from the member once received in the mail
Unlocatable letter (UL) or Outreach letter
This brings mindfulness and meditation into the workplace while helping to manage stress and cultivate clarity, focus, energy, and emotional intelligence.
What is "ZENtauri"