Account Audits
How often are account audits done?
Once a month
How often are call audits done?
Each rep receives a minimum of 1 call audit per quarter.
Do we count VA benefits?
Yes - as unearned income.
How many minutes are you expected to call before you call into work?
60 minutes
Who is the CEO of Centauri?
Adam Miller
How is the RFC calculated?
Must be completed correctly based on an 8hr period.
What 3 pieces of information are needed to confirm someone's identity? What can not be used?
Must confirm first and last name of both the member and person you are speaking with before releasing info or asking screening questions.
DOB, complete mailing address. (Last 4 of SSN can be used as a last resort only).
What are the resource limits for 2021 for an individual and a couple?
Individual - $2000 and couple - $3000
How many decisions do you need before you can become bonus eligible?
30 decisions
Who handles Compass processing errors and who handles Livevox errors?
Anna Westfall and Kyle Larner
What are 3 examples of reasons why we can accept a case other than highest/high contact priority?
Med voc grid rule, domains (2 marked or 1 extreme), unable to sustain a 40 hour work week, meets listing, TERI/CAL case.
How many points is Compass Processing worth in a call audit?
12 points
If a member receives a child tax credit/income taxes, how long do they have to spend this money before we count it as a resource/income?
12 months
If you have a member that speaks Spanish or Arabic, what is the correct procedure and who do we change the account owner to?
Change language in Compass:
Spanish - E-mail: BB.Spanish.Screeners@centaurihs.com to see if anyone can assist - change the account owner to Lucero Garcia.
Arabic - E-mail Amal Abouelsoud, and Shahinaz ELMahdy to see if they are available to assist - change the account owner to Ashley Bennie.
If we are not able to provide the member with the talking points of following up in 60-90 days - what do we do with the case?
Close the case as refused consultative from the summary page.
What word can not be used in our case notes?
Closed (must be self-direct)
What 3 talking points must be covered when stating the fee agreement?
Must explain fee agreement and cover all 3 points: Disenrollment, One time fee, and 25%.
Do we count unemployment?
Unemployment increase – will be counted as unearned income.
What is the criteria to become a Tier 2 SOS?
4.25 accept average, 70% overall approval rating (6 months average), 90% or higher average on call and account audits
What is one plan we work with in which we do NOT say the fee agreement?
AGWA
What is enough info for an adult/child case?
At a minimum, the following must be gathered:
Adults: 2 ADLs, 1 limitation, 1 symptom with frequency, treatment source info.
Children: 1 symptom with frequency, 1 limitation, Milestones/GABS, and treatment source info.
How long should we inform the member it will take to process their claim at the end of the scripting if we accept a case?
6-9 months
What are the steps of the appeal process? What levels or types of appeals can we assist with?
Initial application, reconsideration, ALJ, appeals council.
We can not assist with appeals council or pending ALJ.
What do we do for someone who receives SSDI that's less then 794$ a month?
We complete the screening, and see if they are eligible for the remaining balance in SSI. We would need to complete the full screening, submit a paper application on their behalf, fax it to Sfax, and print it to Sentry.
In order to be exceptional in your call and account audits, what is the percentage needed?
98%