Akorbi
Virtual visit needs interpreter, what platform do you use?
ZOOM
Where do you send ETA emails?
How do you know a member is offered a gift card?
2.0 Profile under Notes from Plan
Can you schedule a visit for a member that is in Humana Texas if they are out of state in New York?
If yes, why?
If no, why?
No, the member must be in the same state as their health plan. The doctor might not be licensed in New York.
Catherine and Jim are in the same household, but Catherine has DEE specialty and Jim does not. Which member's schedule do you look at first?
Catherine DEE member
Scheduled an in home visit, member needs special language interpreter. What notes do you use?
Member is in need of (Insert language) translator for visit, please call the number below provided upon arrival for phone translator service.
a. 214-865-7716
b. Press 1 for Spanish, Press 2 for ALL Other Languages
c. Client id: 10489
d. Authorization code:87
What information belongs in the ETA emails?
Email Subject: Late Provider & Health Plan
Member Name:
Member HICN:
Plan:
Doctor:
Date/Time of Appt:
Reason/Comments:
Walk me through where you find out if we manage the plans gift cards
Toolguide
Can you schedule a visit if the member is out of town, but they know their schedule and when they will be back home?
Yes, you can schedule them for the best day and time for them. Have them check their calendar so they are able to be seen.
Catherine DEE does not have any availability, but when you look at Jim's account there are appointments available to schedule. What do you need to do?
Find a time & day for the members, schedule Jim on at least 1.5 weeks out, choose a day and time that has back-to-back appt slots open. Verify that spouse will be available at the same time finish script, send Catherine's(DEE) HICN to me. Check back on the DEE member's account within 24-72 hours, and add the member to the schedule with Jim.
After scheudling a virtual visit w/ interpreter where do you find the Translation Request Form?
Tool guide, Procedures,
Akorbi Process - For Languages Other Than Spanish
Step #7
Who should you CC on your emails?
My manager(Kayla)
Who do you send a email to if we handle the gift cards?
giftcards@signifyhealth.com and ME(Kayla)
If a member moves states, how long does it take to update the plan to the new state? What should you tell the member and how should you code it?
24-72 hours, you should let the member know "we will have to give you a callback in about 3 days to schedule you when we have your plan updated to new state" code as callback for at least 3 days out.
what does DEE stand for?
Diabetic Eye Exam
When scheduling an ASL in home or virtual visit - how long do you schedule it out? Do you fill out a Translation Request form for both of these types of visits?
2 weeks out AND yes, fill out Translation Request form for in home and virtual ASL
If the doctor is 2 hours or more late, what should you do?
Offer to reschedule the member so they aren't sitting around waiting and wasting their time.
What information needs to be added in the email for gift cards?
Inquiries emailed need to include: Member name, HICN, and Plan name.
Member moved to a new town in the same state, what steps do you take?
Verify the members DOB to make sure that matches. Update the members address, then search for a date & time to schedule the member.
What does PAD stand for?
Peripheral Artery Disease
How long should you wait for a translator to come on the line before letting the member know we will call back at another time?
1 minute
What should you say to a member that is calling in looking for their doctor?
When a provider is running late, verify the member is on the schedule and make sure the date and time are correct. Then, apologize for the members' inconvenience, and ask " Would you like to continue with your appt. today or would you like to reschedule?"
At what section in the script do you mention a gift card if applicable?
After the purpose of the call, before the member verifies Address
Can you schedule a virtual visit with a member that is out of state?