TRUE OR FALSE
If you are speaking to a member and more than one family member has a plan, you only have to create one case in CRM?
FALSE - You must create a case for each family member
What are we referring to when we say "white glove experience"?
We're referring to soft skills. Qualities that can be classified as a personality trait. Empathetic listening, empathy, speaking with ease, and personalization
If a members language preference indicates that an interpreter is needed, what mentor do we reference?
Foreign Language Call Overview
Beside the HRA - what other two forms were included in the Quick Start pkt?
Continuity of Care (COC)
Consent for Release
For the whole call, it will only be necessary to create one case, no matter what we discuss?
FALSE:
You will have the initial call but if you do a pcp change or demo change you must create a case for each one as normal.
Oklahoma refers to their state health assessment as Health Needs Assessment?
FALSE - Health Risk Screening
What is the first step to start taking calls?
Go On Queque
What mentor will walk you step by step through helping member complete the HRA in Guiding Care?
Complete Health Assessment in Guiding Care Medicaid
What does TCPA stand for?
Telephone Consumer Protection Act
Are you able to assist the member with setting up their Go365 account?
NO - you advise they need to get the APP - use the same username and password they used for their My Humana account.
Welcome calls are handled with what is known as the "Black Glove" approach.
FALSE - White Glove approach
Where do we locate the members ID to enter into CRM?
It will populate on Genesys to cc and paste
Name me at least 3 topics that are covered during the Welcome Call: (I listed 7)
Quick Start Guide - HRA - PCP - Schedule an appt with their DR - Go365 - Completion of necessary forms - Transportation Assistance.
Who is allowed to put a number on the Do not call list?
Member or POA
What are the appropriate Wrap-up codes if the Welcome message is delivered?
Welcome Msg delivered- HRS Completed
Welcome Msg delivered - HRS already completed
Welcome Msg delivered - HRS declined by enrollee
If the member is not available, we do not have to create a case in CRM. We just move on to the next call.
FALSE - As always we create a case for every call
What do we have to do to receive the next call?
HIT DONE :)
What mentor will provide you with appropriate scripting on Outbound Calls?
Welcome Calls for OK Medicaid
Name the two classifications/intents that you will be using for making outbound calls.
Communication/Welcome Calls
Outbound Call/Message Not Delivered
What do we do if they member is busy and ask to call us back?
Advise them to call the number on the back of their ID card. (Document the call appropriately)
If the member is busy, we can schedule a call back at a time that works for the member?
TRUE - you set the date, time and phone number based on their preference.
When a call comes in you will hear what tone?
Whisper tone
What mentor do you need to use if the member tells you their address is wrong?
Demographic Changes for Medicaid and MMP Overview
What are the two most important topics that MUST be discussed during the call???
Health Risk Screening and PCP providers
We have to make sure we have the correct PCP listed.
When scheduling a call back, besides the time, what is something else we have to make sure to select?
The appropriate Time Zone