CRM
How do we have CRM named under HSS?
Service Read Only
After obtaining a claim number on speedweb what is the next step?
Use the claim number on ehub
What is a provider refusal?
When a provider doesn't want to cooperate or doesn't agree to return the records back to us
What must be clicked twice to sort the dates from most recent to the oldest?
End Date
True or False: CRM is the only research site where we can locate patient phone number
True
True or false we can use the site id to search for claims on Speedweb
True
When a provider asks if they are required to cooperate and return records back to us, should we say yes?
No, we should never say yes or make them feel like they are forced to cooperate.
Instead, we can ask if there is a reason for them to ask this questions.
What is MRM used for?
To locate medical records
Why do we use CRM?
To locate patient claim number
Can we also use the Humid to search for claims on Speedweb? Yes or No
What is the action and next action new agents need to follow when a provider refuses?
Action: Call
Next Action: Research
What is the next step to take if we can't locate records on Global search?
Use MRM
Can we locate provider information using CRM? Yes or No
Yes
What other research app can we use if we can't locate the claim number on Speedweb?
We use CRM
Who do we email when a provider refuses to return records back to us?
We email Lo's and CC TL
How many times can we follow up?
We do 2 follow ups, after that we must ask for instructions from our Lo's
What must we click in order to take a look at all the claims under CRM?
Click on "Claim Summary"
Once pulling up the site on Speedweb what must we click in order to see all the claims for the site we are working?
Click on DOS Open and RP 1-65
Do we ever argue with providers not wanted to cooperate?
No, please never do that
Where can we locate Ehub on our Hi Humana web page?
HSS