Privacy
A subscriber contacts us with questions regarding their daughter's benefits. You need to set this before beginning any inquiry each time.
What is PPI TOOL.
Case Managers will reach out to CORR and ask for help with benefits, claims, prior authorizations, etc.
What is Amazon Smiles?
Where would you go to keep current with Ops announcements?
What is the Ops Announcements on Amazon SharePoint? (or Ops SharePoint)
When quoting a benefit, it is necessary to check these sections in BQT to make sure you have given the member all of the information they need?
What is Additional Contract Language & Benefit Quote Language?
This resource can be used when you need assistance determining whether Premera should handle the member's inquiry or if it needs to be transferred somewhere else.
What is the Call Matrix?
You must check this tool before you acknowledge a claim, and or Prior authorization what am I?
What is Sensitive DX/PX Code list
This will guide you through the necessary steps to ensure a chat flows, protect member's information, and that you anticipate needs.
What is Chat Flow? (Amazon Member Chat Flow)
You have been instructed not to memorize information, so you must find Premera's tax ID, Plan Code, the list of Amazon ASRs, and VSP's contact number. Which resource contains all the information you need?
What is the NAOI Phone Quick List
You should have this procedure open any time you provide a benefit quote to a member to ensure the information is reviewed and shared correctly.
What is the Benefit Inquiry Guidelines: NAOI Procedure?
Starting 04/01/2018, Premera partnered with what organization to provide Amazon members with support and care for alcohol and drug addiction.
What is Hazelden Betty Ford?
You would use this tool to check for authorization when Facets is down/unavailable.
What is DTT? (Disclosure Tracking Tool)
You attach these to your chat when quoting benefits for members.
What are Benefit PDFs?
A CSR must use this tool to request an accumulator spreadsheet.
What is Project Team template
This is the form you will need to offer a member if they bring up being in a car accident.
What is an Incident Questionnaire? (IQ)
Amazon partnered with them to provide behavioral health services for its members which offers coaching, therapy and medication management. Members will receive personalized care, 24/7 Care Navigator Support, &have access to the Health app. Who are they?
What is Lyra?
You would use this tool to verify what information you need to gather in order to assist different callers.
What is the Auth Tool? (Authentication Tool)
These helpful Genesys tools allow CORR reps to quickly respond to common or frequently asked questions, helping keep responses consistent while also reducing AHT.
What are canned responses?
This system is where you can locate EOBs when a member requests a copy.
What is PRA-Premera Reporting Archive?
You check this tool to see if you can have any adjustments made when a member says they have a lab claim that processed OON and they don't understand why, since they went to an INN provider.
What is the Amazon Benefit Clarification Log?
This partnership started 01/125. They are known for offering on-demand support for obesity & related health issues. We also refer members there when they have inquiries about GLP-1's. Who are they?
What is 9am Health?
You would use this tool if you needed to check if a medication is sensitive or not.
What is the Sensitive Rx Therapeutic Chapter Tool?
Blue2 Messaging training PPT is referred to as a blank.
What is a Job Aid?
I am the resource you would utilize when handling a CSR's request for a member requiring 35 claim adjustments. What am I?
What is the Bulk CLM ADJ Spreadsheet template?
This DME benefit can be used for one purchase per pregnancy and must be quoted.
What is Medical Equipment Preventive?
If a member contacts you to inquire whether insurance can assist with quitting smoking, you would inform the member that they can reach out to what provider for support.
What is Pelago?