Off Road
You: "How are you today?"
Member: "Not good"
Agent: Applies Empathy Suggested "I'm sorry to hear that, if you have a moment I am calling with information about your healthcare coverage; is this a good time?"
Member: "Who handles eligibility? Whats the difference between Apple Health and Molina? "
Agent: (In your own words) The state office (Health Care Authority for WA) determines who qualifies for the coverage and Molina manages the coverage
-Can also reference the provider network, member is enrolled with Molina for benefits and providers
Member turning 65 years old, All States - what actions should they take?
-Applies for Medicare through Social Security Admin
-Once rcvd Medicare card, member can enroll into a Medicare Advantage Plan (Molina offers per script)
-If mbr would like Medicaid AFTER age 65, can apply with their state office (DSHS in WA)
Member: "The letter/ online says I am covered until June 2027"
Agent Suggested: Member Recertified Conversation
Continue to close call with recap and feedback
Member: "I renewed 2 weeks ago, and keep getting reminders"
Agent Suggested: "Great! We were reaching out with a reminder to renew by the June deadline, I will notate the account that you have taken care of your renewal"
Continue to Marketplace if results are unknown, Recap and Feedback to close call
In Mississippi, if the member renews and is active, are they also covered with Dental Benefits? If so, by who?
Yes, you may search Salesforce for references
MS- Dental Benefits Medicaid MS
Vendor- Skygen