Wave 1 New Hire II

Caller Type

100

"Looking to find a podiatrist close to me."

Member

200

"Hi, CVS Pharmacy calling to get an override on medication for J. Smith"

Provider

300

"I'm Roger Smith and I'm calling on my behalf of my wife, Annie"

Member Representative

400

"Checking on the status of an enrollment for an HMO plan for my client."

Agent

500

" Dan, SAN# 1278559556.... can you tell me if cards were issued yet?"

Agent

CRM Navigation

100

"I need a new ID card"

ID Card Management

200

Searching for a ANOC in CRM

RTI Communications

300

I need my EOB resent

OMS

400

Advocate can't locate ANOC in CRM, now what?

Search in EMME

500

"I don't need large print letters; can you stop this please?"

Member Preferences

Search CRM

100

I called 4 days ago for the same issue! Can I get a status update?

CRM Case History

200

Where to find the HIPPA Forms

Member Account Page

300

Something we cannot ask for but can use if they offer it

SSN

400

After completing QuickStart+ documentation you

Associate to policy

500

Interaction numbers in CRM start with

200

ANOC

100

Received their notice of change and clarification on upcoming benefits. What is the Classification and Intent?

• - Classification: Annual Notice of Change (ANOC)
• - Intent: Benefit Information

200

Member can't access their ANOC and would like a paper copy to be resent; what is the classification and intent?

• Classification: Annual Notice of Change (ANOC)
• - Intent: Not Received/Duplicate Request

300

ANOC letters are sent out on what date?

Oct. 1

400

When searching the member's current plan year, if a different plan number displays on the cover of the ANOC, it's not an error. There is an

administrative change

500

You see this in EMME ME001. How did they receive their ANOC?

Digital

Complaint Calls

100

I scheduled a ride yesterday and they never showed up

Classification: Complaints or Compliments  

Intent: All Other Complaints

200

I spoke with a young lady last week named Lori and she was wonderful. I want to let someone know how great of a job she did

Classification: Complaints or Compliments

Intent: Compliments

300

I was referred to a doctor and the office was filthy, he was very judgmental of my religion, and kept telling me what I didn't need as far as my care.

Classification: Complaints and Compliments

Intent: QAA

400

I need assistance on filing an appeal I'm online with the forms. What do I do now?

Classification: G&A

Intent: Filing Instructions

500

I filed an appeal 2 weeks ago and wanted to check on the status.

Classification: G&A

Intent: Status