Job Aids
What is the Job Aid that tells you how to handle SPI?
What is: Outreach: SPI Intake | Datavant Vault All Learners
What is the next step that we do if 1 provider/member verifies, but the another provider/member does not?
What PEND is Used for Contact information and we did NOT reach the site?
What is PNP4
PNP004: Invalid Contact Information: We attempted to speak with Medical Records at [PHONE NUMBER], number is an invalid phone number. We researched the provider(s) on [WEBSITE(S) URL]. We were unable to locate a working number. Other phone numbers attempted were: [PHONE #S ATTEMPTED]. Submitting request to the Health Plan for the Location of Care for the Member(s).
What is the Quality Monthly Goal?
What is 90%
How many Charts is needed in order to schedule for a CRS?
What is 15+
What is the contact information for Request Manager Support?
Bonus 2 Points: What is the Job aid?
What is 800 367 1500 Opt 5 Line 2 or email requestmanager@cioxhealth.com?
Bonus: Outreach: Request Manager | Datavant Vault All Learners
Where do you go to include DOS on the Provider Package, if applicable?
What is the Pull List.
Do we PEND or ESCALATE for Wrong Name of a Member?
What is: Escalate
What is the 1 thing that we must advise the site on EVERY call before we discuss any information?
What is - this is on a Recorded Line.
What is the Job Aid for sending a Shipping label?
Bonus Points: What is the Math for the weight of a package?
What is: Outreach: Special Handling, Shipping Labels, Supply Requests | Datavant Vault All Learners
Bonus: Charts / 5 = lbs
If a Provider Verified for being at the site, do we choose P or WP or UV or O?
What is P?
Do we submit a PEND for Request Payment if the Site's amount is less than the approved amount in the Health Plan?
If Yes, what PNP?
If No, what do we ask for?
What is No, only advise to fax in a W-9 and Invoice.
What are the return methods we can offer to the site?
What is; Fax, E-mail, Request Manager, provider Portal.
If the site advises they use a 3rd Party Copy Service, but request the fax sent to them. Do we send it or do we update for 3rd Party Copy Service?
What is: We update to reflect Copy Service and Escalate.
1st part: When completing a test email; what do we have to advise?
2nd Part: Where can you find the Email Template?
What is; There is a two step process, the site needs to check spam/junk folders and a response is required in order to confirm the email is valid.
Template: Outreach: Emailing Provider Sites | Datavant Vault All Learners
What do we do if there are 4 charts. 3 Charts are in Coding Status and 1 is in PNP11 Status, but the records are still showing scheduled?
What is PNP the 1 record and notate: NA: 0 charts to go.
Do we PNP1 on the 3rd, 5th, or 10th attempt?
What is 5th.
Are we required confirm a point of contact for future medical record request inquiries?
What is: Yessssss.
Bonus points: Share your best positioning with the group!
What tracker do we use to report schedules?
What is: S.E.A.S Schedule Tracker.xlsx (sharepoint.com)
What are 1 Do Not Touch Project and 2 Do Not Touch Statuses?
What is the Job Aid Link?
Projects
Advantasure Digital Direct
▪ Aetna Digital Direct
▪ Alliant Health Plans ACA Digital
Direct
▪ Anthem ACA Digital Direct
▪ BCBS TN MRA DIGIT
▪ Brown and Toland Digital Direct
▪ Clover Digital Direct
▪ Devoted Health Digital Only
▪ Healthspring Digital Direct
▪ Optum Digital Only
▪ Oscar Digital Direct Only
Status'
300 ORGs*
▪ ORGs with Agents names*
▪ Account Management
▪ Complete
▪ Escalated
▪ Expired ORGs (Project Due Date Has Ended)
▪ Pend Research
▪ PNP
▪ PNP Closed
▪ PNP Released
▪ Research
▪ Research2
▪ ROI CNA Research ROI Partner
▪ ROI Pend Research
▪ ROI Research
▪ Special Handling in the Agent tag
Link: Outreach: Do Not Touch List | Datavant Vault All Learners
What do we do when a site states they are CIOX?
What is ask for Site ID and Escalate for ROI Research.
What PNP do we use if the IVR indicates, "The Party you are trying to reach is blocking your calls." And there are no other contact numbers available?
Who is Our TQM?
Who is Sheena Douglas
What Tracker do we use to report Technical issues?
What is: Team Kellie Tech Tracker.xlsx (sharepoint.com)