Deductions Babyyy!
How well Do You Know?
Ugh HIPPA's
Bonus Me Plz!
Message Alerts!
100
If the CSR had a hold time 1 minute 15 seconds. Would you deduct or coach?
You will Coach.
100
Do you work for Maximus or Cover Virginia?
You work for Maximus but our contract is called Cover Virginia.
100
Brittany Elder called in on behalf of Brittny Jenkins, The Melva Jones and Anwar Smalling to check the status of their application. No one is listed as AR or POA the only individuals in the household are The Melva Jones, Chris Brown, Anwar Smalling and Brittny Jenkins. The CSR provided case information. Is this a HIPAA?
Yes, because Brittany Elder is not listed as person in the household.
100
Old MACDONALD had a farm
E-I-E-I-O
And on his farm he had a cow
E-I-E-I-O
With a moo moo here
And a moo moo there
Here a moo, there a moo
Everywhere a moo moo
E-I-E-I-O
With a moo moo here
And a moo moo there
Here a moo, there a moo
Everywhere a moo moo
100
Do we send disconnects to Brittany, Mathew and Anwar ?
No
200
Where would you deduct if the CSR completed the application with the mother, son and grandmother but the mother only claim the son as dependent.
Policies and Procedures.
200
Who has the Hottie Sauce at Popeyes?
200
If a provider called in an ONLY provided their name , Client full name, DOB, SSN and Address., is this a HIPAA's ?
Yes, The CSR did not ask for the Provider's NPI #, Provider's Agency Name.
200
BAAABBBYYYYYYYYYYYYYYYYYY shark
Baby shark, doo, doo, doo, doo, doo, doo.
Mommy shark, doo, doo, doo, doo, doo, doo.
Daddy shark, doo, doo, doo, doo, doo, doo.
Grandma shark, doo, doo, doo, doo, doo, doo.
Grandpa shark, doo, doo, doo, doo, doo, doo.
200
What email address would you send to for HIPAA's?
CoverVAHIPAA@maximus.com
300
Caller: Hey my name is Keshia Jones I'm calling in on behalf of my grandmother to check status of her application.
CSR: Are you listed on her Case as AR?
Caller: No, but I did complete the application on her behalf.
CSR: let me search VaCMs to verify if you listed on the case as an AR. Im sorry but you are NOT showing as an AR on the client case.
Caller: But, ma'am they gather my personal information because she Live in the home with me.
IF the CSR did not assist the caller where would you Deduct?
All solutions.
300
When I was 10 my sister was half my age. Now that I am 40 how old is my sister?
35
300
The caller provided their full name, DOB, and SSN.
Is this a HIPPA?
No, because this will be considered failed IDP.
300
Yeah, I'm gonna take my horse
To the old town road
I'm gonna ride 'til I can't no more
I'm gonna take my horse to the old town road
I'm gonna ride (Kio, Kio) 'til I can't no more
300
What time should your calibration sheet be sent in by ?
9 A.M.
400
Where would you deduct?
If the CSR did not say " May I Please have the individual in which you're calling about and are you authorized to speak on behalf of that person".
Policies and Procedures.
400
If you were born 17 years ago, how old would you be?
17
400
An Authorized Representative called in on behalf of a client, the Authorized Representative provide their name, Client name, DOB, SSN and Address. In VaCMS the View data says “ No”.
Is this a HIPAA?
No, because we no longer pay attention if it says “View Data”
400
All the single ladies ...
All the single ladies, all the single ladies
Now put your hands up
Up in the club, we just broke up
I'm doing my own little thing
Decided to dip and now you wanna trip
Cause another brother noticed me.
400
Immediate Coaching should be sent out if?
MUST provide five.
- CSR did create a Connection Point for the incident ,
- The contact doesn’t match the contact . ( Contact is in the wrong name or child's name )
- A bridging issues ,
- CSR had the client on hold for more than 20 mins for majority of their calls,
- A communication form is needed for LDSS ,
- CPU needs to be notified ,
- A application is missing information ,
- a application was completed incorrectly ,
- a renewal is missing information ,
- a RMC should have been completed ,
- CSR didn’t complete the RMC correctly / Missed information
- a incident should have been escalated ,
- CSR did something inappropriate during the call etc ….
- Did not obtain a signature for RMC , App , Renewal
- CSR having the same trends over and over
- Did not escalate their contact / Create a Task
- Client wanted to cancel their coverage and the CSR did not do anything
500
"Hey my name is James Brown I'm calling because I was un happy on my previous job now have a new job and would like to report my income. "
Would this be a point deduction?
If so where would you deduct?
Yes.
EMPATHY.
500
How do you make 30 cents with ONLY two coins?
The other coin is not 25 cents.
One coin is nickel and the other coin is quarter.
500
- Jazell Wrough called on behalf of her daughter Valerie Vandenbroucke to verify if she has coverage
- The caller provided the clients name , date of birth , social security number and address
- The caller placed an unknown women on the call and that person provided the last 4 of Valerie’s social security number and authorized the caller to speak on the behalf of Valerie
- The customer service representative advised the caller that the client is active and renewal date is 11/30/2022
Is this HIPAA?
Yes , because the original caller was not listed on the case and the client should have provided their Full name, DOB, SSN and Address. 
500
Dame mas gasolina!
Dame mas gasolina!
Dame mas gasolina!
Ella prende las turbinas,No discrimina,No se pierde ni un party de marquesina,Se acicala hasta pa la esquina,Luce tan bien q hasta la sombra le combina,Asesina, me domina,Anda en carro, motoras y limosinas,Llena su tanque de adrenalina,Cuando escucha el reggaeton en la cocina.
500
If it has been two months since the client had her baby and she currently have PG coverage, does she need to submit a new application?
No, if they have PG and FAMIS coverage they are cover for a year.
