Script Flow
How many call attempts will we be doing per member?
3 call attempts
TRUE OR FALSE
only members who have an OTC benefit will receive a Spendables card
False
every member will receive a new Spendables card
how many questions are in the closing section?
3 questions
What needs to be mentioned at the end of every Inbound call?
call closing with brand name, TTY, CSAT survey
*Flu shot if it is the season*
What can be used to Verify HIPPA for Inbound/ Outbound
Outbound Calls: We should confirm the members full name, as it appears in the system. In addition to one of the following (D.O.B., Address, Health Plan/ Product ID)
Inbound Call: The agent confirms that we are speaking with the correct person (this does not count as a verifier) Members must verify two identifiers (D.O.B., Health plan/ Product ID, Address and Phone number)
What Digital Tools do members have available to them?
As a member, you have digital tools available to you. One of these tools is the Wellcare+ mobile app. This tool will allow you to view your benefits on the go, locate providers, and more! You can also locate this information by visiting wellcare.com and logging into your member portal.
If the member states multiple benefits in the closing question, how would you document those?
If the member states multiple benefits, please document the first benefit they mentioned. If benefit isn't listed, please select other and document in dialer.
Disconnected call.
DO NOT USE (HUNG UP)
If a member does not want to be recorded or verify HIPPA, what disposition would you use?
Refused call: The caller refused to verify HIPAA or be recorded
Which Benefits have a $0.00 co pay?
routine exams for Dental, Vision, and Hearing
If a member does not have any suggestions in making their coverage easier to understand and use, what would you type instead of using (N/A)
member did not have suggestions
Which Action code needs to be selected every call?
member temperature
agents must document one of the three Member Temperature Action Codes for each completed call, based on their assessment of the member's attitude at the end of the interaction. This determination is not to be asked directly; agents should use their best judgment.
What are the phone numbers for LWC Welcome back SC, and LWC Welcome back SC-DLS
LWC Welcome back SC: 855-444-3219
LWC Welcome back SC-DLS: 833-286-1376
If a member has SSBCI with their Spendables, what can they use that card towards?
out of pocket dental, vision, and hearing costs,
approved over the counter, or OTC products,
Utilities, Rent
Gas Pay-at-the-pump,
Healthy foods,
Home improvement and Safety items,
Pest control
What is considered Outbound Call Unsuccessful?
Busy Signal, Callback Requested, Deceased, Disconnected Call, Do Not Call, Fax Modem, Hung Up, Immediate Callback, Left Message Third Party, Manual Callback Requested, No Answer, Not Attempted, Not Interested, Refused Call, Transferred Call, VM Not Left
How many action codes may be selected?
up to 6 action codes may be selected
What is the purpose of Welcome Back campaign?
To thank members for staying with their specific plan and influence impactable members to be more satisfied. The goal is to encourage each member to feel special and educate them on benefits and service to increase member satisfaction and experience with plan selection.
What 3 ways can a member use to activate their Spendables card?
You can activate your card by calling (1-855-256-4620) at any time, logging into your secure member portal and navigating to [Wellcare Spendables] or downloading the [Wellcare Spendables & Rewards App]. This will be replacing the [Healthy Benefits Plus app]
When documenting in Care Connects what are the Top level Reason, 2nd Level Reason, 3rd Level Reason, and Action Item?
Top Level Reason: Outbound Campaign
2nd Level Reason: Outbound Member Services Follow up
3rd Level Reason: MSCUN-MSC Unsuccessful, MSCSC- MSC Successful
Action Item: CSEDUC-Educated Caller, CSLMM- Left Message, CTOUNS- Outbound call Unsuccessful
What is the Campaign Code for STARCare?
Welcome Back SC