System/ Function
Account Summary
MIIM Navigation
Person Search
HIPAA
100
What does ODM stand for?
What is online document management?
100
What are the three adresses you can view in the meber info tab
Permanent, Temporary, Mailing
100
What is important to close when you finish or else it might not display the next time you open it.
Account Summary Window.
100
When the member identifies and identifies a caller as a third party?
Create a quick contact.
100
First/ Last name, DOB, Member ID or Medicaid number.
What are the essential pieces of info needed to verify an account?
200
What pulls up the members details from a system called GPS?
CTI
200
Eligibility tab
What displays reference information regarding an account?
200
What is the function you double click before exiting an account?
Wrap up.
200
When CTI is unable to locate a member from VCC
When do you have to perform a manual search?
200
Present, Past and Future health conditions.
What is PHI?
300
What is the proper way to start a new member request?
New Phone Call.
300
What holds numerous pieces of information that may help you with member inquiries?
Summary Tab
300
When do you launch account summary?
When MIIM tells you too/ when the button appears.
300
When do you create a prospect? HINT: Text book answer and when you are ont he floor answer.
Text book answer: When no application is found When you are on the floor: Never!
300
What might a PHI or HIPAA violation effect?
Integrity
400
What is a queue of work assignments that is specific to a single user?
Worklist
400
What is the four main points of interest within the dashboard tab?
Member Interaction, Medical spend, Premium Info, Rx Spend
400
What is the number of intentions listed under member?
7
400
What do we never provide to third parties?
Social Security number, HICN
400
Health Insurance Portability and Protection act
What does Hippa Stand for?
500
What is an application to give you a single end to end tool to view issues and efficiently manage member touch points?
MIIM
500
What is only available on active accounts?
Dashboard.
500
a 360 degree view
What is it called when you can see everything in the account?
500
What is the box that you click within MIIM when your results show up and the member verfies themselves before proceeding to the members account?
Verify that caller is member.
500
CTM, WAPMO, Fines, loss of job, Member loss
What is a possible consequences of a Hippa violation?
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