Carolina Complete Health Service Transformation
True or False: CCH must verify every call that comes into the call center and document the call in OMNI?
What is True?
Who should you send the DMR template request to?
Who is Laura Tapia-Aguirre, Shauntel Williams, and cc sup.
What is the amount that members can earn annually?
What is $75
What three valued added services are geared for mom and baby?
What examples does ModivCare offers urgent trips for covered services to be scheduled with less than 2 days notice?
What are
If a caller is unable to fully verify identity, how do you document the call?
What is Select Submit - Not Verified, answer the Wrap Up screen questions, and document details in the additional call summary notes.
Who should escalation request be emailed to?
Who is all supervisors?
What is the special note advised to members from the website?
What is Note: My Health Pays Rewards are awarded through claims processing. You may see a slight delay in processing time.
Which VAS is for school age children?
What is School Supplies, Math and Reading Tutoring and Youth Programs.
What system provides timely information related to known issues impacting providers?
What is the (KIT) Known Issue Tracker.
When are you required to review other insurance with the member?
What is if the member has addressed other insurance in the past 30 days, you can bypass asking about COB.
If your request for vacation and it is denied in NICE IEX what are your next steps?
What is request a Manager override and send to all sups.
There are two new rewards that were never offered in previous years. What are their names and amounts to earn?
What is Annual Mammogram, - $25 and Colonoscopy - $25.
Which two programs do we pair with YMCA?
What is YMCA Blood Pressure Sef-Monitoring Support Program and YMCA Pre-Diabetes Prevention DPP Support Program.
What does the TruCare Cloud system, allow you t review?
What is
Anytime during the call.
Who should you send the Peer 2 Peer email request to?
Who is all supervisors and the P@P team email.
What three test must be completed in order to earn the Comprehensive Diabetes Care reward?
What is
How many weeks are offered with the Weight Watchers Program?
What are members can enroll in a Weight Watchers program, which includes, 10 weeks of Weight Watchers digital and web-based classes and workshops, and access to 14 weeks of online tools per plan year. This program is free to eligible members.
What functionality is available in Availity Essentials for Centene providers?
What is
When must an interaction number be provided?
What is interaction numbers are required to be offered when the call pertains to Grievance an Appeals, or the caller request it.
Who should you send Negative Balance Request to?
Who is your team lead and sup? If team lead is out of office send to all team leads.
Which reward must complete all six visits with assigned PCP. 2, 4, 6, 9, 12, and 15-month infant well care visits.
What is Infant Well Care Visit?
Which two Value Added Services require doctor referral and prior authorization?
What is Hearing Aids and Natural Healing.
What language assistance does Carolina Complete Health offer to all members for free?