Using NGD
Coverage and Benefits
Hodge Podge
Keeping it Private
Handle that call
100
Explain the general process you would follow to use the language line with a caller
What is connect to language line, speak with caller and interpreter and assist consumer.
100
This is the difference in an escalation and a transfer.
What is an escalation is the process of sending a requesting to another area for resolution while a transfer is the process of sending you call to another party for immediate resolution.
100
This is the step you should do after passing disclosure on every call (assume you have logged all scripting up to this point)
What is check consumer messages.
100
This is the classification of information that csr's are expected to protect during phone calls and only release to those that are authorized.
What is phi and pii.
100
If you are unsure of a procedure and that information isn't in scripting, these are the other resources you can use to to assist a caller (not cco learning).
What is reference materials and job aids (in ngd)
200
This is the screen that you see when you first log in that has both the user alerts and feedback applets.
What is the Home screen
200
These are the list of benefits that are covered by all plans and cannot have a yearly limit applied to them.
What is Essential Health Benefits.
200
Define either a State Based Marketplace (SBM) or a Federal Based Marketplace (FBM)
What is sbm are ran by state, fbm is ran by federal gov't.
200
These are some common rules on how to protect your information from fraudulent use.
What is look for official logos / communications from DHS and Health Insurance Marketplace as well as be aware of promotions that seem too good to be true.
200
(regarding the call flow) After actively listening and confirming needs, this is the next step in the call flow
What is Select a resolution path.
300
This is the Screen that you will complete the majority of your phone calls on?
What is FFM Contacts Screen
300
These are some ways to get coverage other than the marketplace
What is medicare, job based coverage, Medicaid, private insurance, parents policy if younger than 26, etc)
300
There are some ways that scripting directly affects the consumers
What is makes sure all callers get the same consistent and accurate information.
300
To what extent are you as a csr supposed to release a callers information even if they are authorized?
What is extent necessary to carry out marketplace functions.
300
(Regarding the Call Flow) After reading the welcome and state script, what is the next step in the call flow?
What is actively listen ask probing questions and confirm needs of caller
400
These are some options other than name that you can use to search for your caller.
What is SSN, DOB, user id and or application id number.
400
These are the 4 levels of coverage
What is Bronze, silver, gold and Platinum.
400
There are some reasons that we log scripting (other than because quality said so)
What is impacts on scripting update and helps with continuous training improvements.
400
These are some of other pieces of disclosure that you can gather other than the required pieces. (list at least 3)
What is address, application id, SSN, phone numbers or user id
400
This is the applet that you would find a consumers information in if they do not have any information on healthcare.gov.
What is NGD contacts applet
500
what is the purpose of asking probing questions (irony intended)
What is to make sure you have all the information to completely help the caller.
500
These are some of the key benefits to the marketplace (list 2, wording must be similar to scripting)
What is Accress to free preventive services, coverage for pre-existing conditions, coverage for children up to 26, etc, referral to scripting also is a valid answer)
500
these are some features of high quality customer service. (must be close to answer to receive points)
What is modeling courtesy and professionalism as well as providing accurate and complete information.
500
These are some effective ways to manage silence (yes I realize this doesn't fit the category, get over it)
What is explain why there will be a gap in coverage.
500
These are some actions that a good CSR can do to keep up with changing marketplace information
What is reading absorbing and applying new information and reading training alerts to provide best service possible.
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