HIPAA
HIPAA stands for
What is Health Insurance Portability and Accountability Act
You can discuss/share member PHI with confirmed
POA- Power of Attorney
AR - Authorized Representative
Member states I just seen my doctor, I don't need to see anyone else.
Sees Doctor Regularly
When will the Rewards Card arrive? When will UCard funds be uploaded?
3-4 weeks after completing the HCV. 7 Business Days after completing HCV
Lose a 100 points
Better Luck Next Time
Name three (3) pieces of information that can be used to complete the HIPAA verification requirement with a caller.
Member’s Full Name
Member’s Full Physical/Mailing Address
Member’s Full DOB
Member’s Subscriber ID
Member’s Phone Number
When speaking with a non member you must ask
Does "member" agree/authorize for you to speak/schedule on their behalf
I'm not interested in a visit right now maybe later in the year and disconnects the line
Talked to Member
What must be provided to all Outbound calls
Recording disclosure
What is always coming but never arrives?
Tomorrow
If a member agrees to Text and/or Email communications for the first time or changes an email/mobile number what must be done
Read Text and/or Email Disclosure
If a non-member is scheduling for two or more household members, select the following when prompted with the pop-up (4)
What is
√ Book same appointment
√ Copy contact
√ Copy call script
√ Copy non-member consent
Family member (non-member verified) informed I don't think they (member) would be interested but you will have to speak to him/her. Takes toll free number.
Talked to family
How many times are you required to attempt to handle reluctance?
At least once
What never asks a question but gets answered all the time?
Your cellphone
A Complete Physical/Mailing address includes
The house number or building number, the street name, the apartment/condo/unit number or letter, and the city and state.
Scheduling coordinators may share the following information with non-members once they ensure the non-member is authorized to schedule appointments on the member's behalf (total of 5)
After hearing 4 key points member informs "I'm not interested and never will need this, don't call this number again". Accepts toll free number.
Do Not Call
For Outbound calls, when are you required to advise that the call is being recorded? Choose all that apply.
A)Before HIPAA verification
B)Before verifying PCP information
C)Every time you speak with a Member
D)When Member Services joins the call
A)Before HIPAA verification
B)Before verifying PCP information
Its your Lucky Day!!!!
400 points for you
A Full Physical/Mailing address includes
The house number or building number, the street name, the apartment/ condo/ unit number/ or letter, and the city and state to include cardinal directions, street type and zip code.
What is often forgotten during non member verification when non member answers yes to speaking on member behalf
"with this call" or "on this call"
Talked to member - set callback
Name the three (3) scenarios that are considered serious call infractions and will result in an “Autofail” for QA review.
Any HIPAA Violation
Unprofessionalism
Data Manipulation
How can you add 8 eights to get the number 1000
888 + 88 + 8 + 8 + 8 = 1000