Audit 101
Improves Compliance, provided better customer service, evaluates representatives' performance, improves training and coaching
What is the importance of conducting regular call audits?
Enjoys music and playing guitar
Who is Matt?
Renewal guidance for UPMC for You Members
What is MA Redetermination?
Lists each topic agents should mention based on the campaign
What is Nav Hub Campaign Grid?
Offers connections to local resources
What is PA 211?
eCIS, audit form, CCD, talking points/scripts, NICE
What tools are needed to complete an Audit?
Loves to cook Italian
Who is Vasuki?
UPMC for You members are offered resources to help with SDOH needs
What is Social Determinants of Health (SDOH)?
You will not need to access this system.
What is MC400 Downtime Site?
The retention program will proactively educate UPMC for You members about how to renew their/their child’s Medical Assistance (Medicaid) prior to their renewal date to avoid losing in coverage.
What is the goal of the program?
This helps you to avoid conflict and misunderstandings
What is Active Listening?
Six-word description
What is "What's my Story"?
Renewal guidance for SNP/CHC Members
What is SNP Redetermination?
Primary avenue for call documentation
What is CCD?
A mode of communicating with individuals using pre-recorded messaging and responses. Callers can navigate through messaging without a live agent
What is IVR?
Any systematic process of determining whether a product or service meets specified requirements.
What is Quality Assurance (QA)?
Has 18 chickens and 4 dogs
Who is Wendy?
New UPMC for You Members are welcomed and introduced to the Health Plan
What is New Member Welcome?
DHS resource that indicates member’s renewal, start, end dates. Etc.
What is eCIS?
CHC SCA Hub and Department of Human Services (DHS)
What are Common Transfer Destinations?
Minimum 3 calls per week per agent, Complete the Performance Evaluation Summary Report weekly (by EOD Friday), Ask questions
What are my responsibilities?
A creative person looking for a relate adventure
Who is Dan?
Referral process to assist UPMC for You members in need of Medical Transportation
What is Medical Assistance Transportation Unit (MATP)?
Teams location where the latest agent talking points are stored.
Navigation Hub Talking Points
Coverage for individuals who are eligible for both Medicare and Medicaid.
What are Special Needs Plans (SNP)?