Frozen
Empathy statement: Using a descriptive word to reassure a patient's feelings demonstrate our attempt to connect. T/F
F. Using a descriptive word to RESTATE a patient's feelings demonstrate our attempt to connect.
Which business area impact our CAHPS results the most?
A. Pharmacy
B. Providers
C. Surveys
D. Operations Customer Service
D. Operations Customer Service
Which system do you utilize to clock in and out after training?
A. BMS
B. MYTP
C. IEX
D. AWS
B. MYTP
Which system can you use to update your direct deposit information?
A. Centene Workday
B. MYTP Workday
C. BMS
D. IEX
B. MYTP Workday
Emotional intelligence is about being nice to the member's.
T/F
False. Be Honest
In the ____ stage you will help members understand what Medicare is, who qualifies, and how to get enrolled. Which part of Medicare will help cover member medications they are taking while being admitted into the emergency room?
A. Understanding Plan Details
B. Medicare Basics & Enrollment
C. All of the above
D. Pharmacy Support
B. Medicare Basics & Enrollment
Who do we NEVER refer the member to ?
A. SSA
B. CMS
C. QA
D. CCHL
B. CMS
Part B insurance help beneficiaries pay the cost for hospice care.
T/F
False. Part A insurance help beneficiaries pay the cost for hospice care.
When should you avoid using the preemptive acknowledgement technique?
A. When a customer asks to purchase a product you know is out of stock
B. When you discover an error before the customer realizes it
C. When an angry customer asks to speak to your supervisor
D. When a customer has had to wait longer than normal for service
C. The preemptive acknowledgement will not work once a customer is already angry.
Medicare is replacement insurance for members who were dual eligible. T/F
True
Organizations creates a network with doctors and hospitals to provide healthcare to members.
T/F
False. Organizations creates a network with doctors, hospitals, and other providers to provide healthcare to members.
Medicare Star Ratings determines if a member is eligible to be with Medicare.
T/F
False. Medicare Star ratings determines if an insurance provider is eligible to work with Medicare.
I assisted a member last week. Reports show member called back in again two days later about another issue. I completed FCR (First Call Resolution) T/F
True
Active Listening: pausing, reflecting, setting expectations. T/F
F. pausing, reflecting, confirming
When is the CAHPs survey sent out anonymously to a random sample of members?
A. August/February-June
B. April/March-July
C. March/Oct-December
D. February/March-June
D. February/March-June
What is the difference between same day and formal grievances?
A. The complexity of the grievance
B. The intensity of the grievance
C. The resolution of the grievance
D. Who can file the grievance
C. The resolution of the grievance
First Call Resolution is resolving a customer's concern on the initial call with the member's assistance.
T/F
False First Call Resolution is resolving a customer's concern on the initial call with little to no assistance form the member (no homework for the customer)
Which part of Medicare will help cover member medications they are taking in the hospital?
A. Part B
B. Part A
C. Part D
D. Part C
B. Part A
A mirror on the wall will confirm your mood. T/F
F. A mirror on the wall will confirm your FACIAL EXPRESSION.
For Medicare Part D CAHPS is 15% of the metric for the Medicare Star Rating
T/F
False
The claim submitted by the doctor is paid by Medicare.
T/F
False. The claim submitted by the doctor is paid by the insurance company.
What is the most impactful thing you can do to prevent negative customer emotions?
A. Spot the problem before the customer gets angry.
B. Cover up your mistakes so the customer doesn't find out.
C. Resolve the member's request
D. Listen and let the customer vent about the issue.
A. This lets you acknowledge the situation and offer a solution before a customer gets upset.
What do you put inside the circle when you do the circle of influence exercise?
A. Mistakes you've made and need to fix.
B. The things you have control over.
C. The things you have no control over.
D. Anything that comes to mind.
B. The inside of the circle represents your sphere of influence, so things you can control go on the inside.
Which system do you use to check your time?
A. BMS
B. MYTP
C. IEX
D. AWS
A. BMS
Collect: Providing the information needed to determine the concern of the member while keeping the call efficiently moving yet still addressing worries, concerns, and questions. T/F
F. EXTRACTING the information needed to determine the concern of the member while keeping the call efficiently moving yet still addressing worries, concerns, and questions.