Non Member Involvement
What must you state after Non Member Involvement question
" On this call"
If member would like information resent about the housecalls visit what are your steps?
Confirm HIPAA
Choose correct communication ( PCP Letter, Assessment, Introduction letter)
Confirm Mailing address
Inbound Branding Process
Ask for phone number and FULL name
Brand the call " Optum housecalls on behalf of ...."
If scheduling interpreter visit what must you notify member of?
Take up to hour and half
What is the correct recording disclosure
" THIS CALL is being recorded for quality and training purposes"
What two pieces of information do you need for Non member verification?
Full name and relationship
Can authorized non member update mailing address
No, Only member or POA
On inbound transfer call from member services what must you make sure to ask before transfer?
Is member fully HIPAA verified
What do you have to ask once you Brand and open call?
Are you familiar with housecalls?
What do we need to have on file in order to schedule a virtual visit with an authorized non member?
SMS or Email consent checked off under member contact tab
If a non member answers and say they are not authorized to speak for member what is the next step?
Offer Toll Free Number
Are members able to confirm Mailing address instead of Full address for HIPAA
YES
For non member question can we ask "So does the member allow for you to schedule appointments on their behalf right?"
No- that is a leading the question on
" Does Mr/MS X allow to your involvement to schedule appointments on their behalf"
If member brings anything up outside of housecalls what's your next step?
Transfer to member services - DO NOT offer any information about their plan or ANYTHING outside of housecalls and scheduling (DO NOT TELL THEIR THEIR REWARDS ON UCARD DOES NOT EXPIRE)
If someone calls and doesn't provide name or phone number and asks if we are UnitedHealth Care what do you say?
This is Optum Housecalls
If a non authorized non member states no to non member question and stated member is not interested what is your status?
Not interested
What is a complete address vs full address?
Complete- 123 Main APT 21 Appleton Wisconsin 54136
Full- 123 W Main Street APT 21 Appleton Wisconsin 54136
When scheduling household members can you ask if its the same full address?
No that is a HIPAA fail they MUST provide Full name DOB and full address for household member
What is the authorized non member note on non scheduled call?
Summary- Non member Involvement
Notes- HCV details were released on call hcv was not scheduled Authorized non member.....
What information can we read off to an authorized non member on call script after HIPAA?
PCP and Home details (ONLY IF ALL DETAILS ARE PRESENT AND COMPLETED) (full PCP name address and phone number)
If an authorized non member calls in to verify members appointment/rewards what do we need to make sure to do?
ASK NON MEMBER QUESTION
STATE " ON THIS CALL"
VERIFY HIPAA
Where can else can you find an address on members account to verify HIPAA?
Address Repository
When helping LHP reach out to member what do you have to do when you reach member?
Brand the call
HIPAA
State reason for calling
How do you offer visits in order
First available
Future date
Virtual visit (if eligible)
Rewards
Virtual visit ( if eligible)
TFN and Web address (web address MEMBERS ONLY)