Medicare &Medicaid Basics
What age do you typically qualify for Medicare?
65 years old
What does UHC stand for?
UnitedHealthcare
What’s the first thing you say when answering a call at UHC?
“It’s a great day here at UnitedHealthcare…”, “Hello this is *name* from United Healthcare…”
What is a copay?
A fixed amount paid for a covered service
Why is HIPAA important in healthcare?
It keeps patient information safe and private
What is the main difference between Medicare and Medicaid?
Medicare is age/disability-based; Medicaid is income-based
How many people does UHC serve across the U.S.?
About 50 million
What does “funneling” mean in customer service?
Narrowing down a general concern to a specific issue
What does “premium” mean?
The amount paid for insurance coverage
What does HIPAA stand for?
Health Insurance Portability and Accountability Act
Can someone be eligible for both Medicare and Medicaid?
Yes, they are called “dually eligible”
What is UHC’s mission?
Help people live healthier lives and make the health system work better for everyone
What does “active listening” involve?
Paying full attention, interpreting meaning, and responding appropriately
What is a formulary?
A list of drugs covered by a health plan
Why is HIPAA important in healthcare?
It keeps patient information safe and private
What does Medicare Part D cover?
Prescription drugs
Name one country outside the U.S. where UHC operates.
Brazil, India, Portugal, or UK
What does “member-centered care” mean?
Focusing on the member’s needs and experiences
What does “pre-authorization” mean?
Approval needed before receiving certain services
How many pieces of infomration do you need to access a members account and which ones?
You need 3 pieces of information, it can be first and lastname, member ID, Medicare ID, date of birth or permanent address
What does D-SNP stand for?
Dual Special Needs Plans
What are the 4 Ps in UHC’s marketing strategy?
Product, Price, Place, Promotion
What’s one way to avoid “dead air” on a call?
Keep the member informed or engage in small talk
What is an EOB?
Explanation of Benefits – a summary of charges and coverage
What should you do before accessing a member’s account?
Verify their identity (authentication)