Mentor
C/I
Customer Interface
miscellaneous
Medical Benefits
100
What mentor would you go to for a PCP change?

PCP changes for Medicaid and MMP Overview

100

What C/I would you use for a member calling about locating a provider

Provider/Locate

100

What screen in CI would you use to change a PCP in CI

PAMG
100
What do we use on every call?

Mentor

100

Do we cover ultrasounds for children under 21?

  • Ultrasounds:
    • 1 abdominal or vaginal ultrasound in the 1st trimester
    • 1 ultrasound after the 1st trimester
    • 1 additional detailed ultrasound is allowed to identify or confirm a suspected fetal/maternal anomaly
200

What mentor would you go to for Demo change?

Demographic changes for Medicaid and MMP Overview

200

What ci would you use for a member calling to change their phone number?

Demo/change

200
What screen in CI would you use for sending out a id card in?

PAID

200

What do we have to make on every call?

Cases

200

Do we handle Dental? if no who does

  • Covered directly by the dental plans contracted with the Oklahoma Health Care Authority (OHCA)
300

Which mentor would you go to for provider locate?

Provider search Medicaid and mmp overview

300

What ci would you use for a pcp change?

pcp/pcp change made

300

What screen do we go to search the member by name dob and zip?

Pesl

300

What is something you must do everyday at the end of your shift?

Make sure you never have any open cases

300

Do we cover eye exams for adults? 

  • Coverage to treat a medical or surgical condition only; no coverage for routine eye exams
400

What mentor would you go to for Rewards?

go365 for Medicaid overview

400

what CI would you use for a member calling in to see how much it would cost them for surgery 

Benefits/verification

400
how do you log out of ci?

you just exit out of it

400

What are two things we have to leave on tcp notes for them to be fixed? 

Time and reason

400

Do we cover allergy services/testing?

Yes

500

What mentor would you go to for Id cards?

Id card overview Medicaid and mmp

500
What CI would you use for a member calling in to check status of an auth?

auth/referral intent authorization

500

What screen in CI do you go to when searching with the H number

UMID

500

What is the first thing we pull up every morning?

Launchpad/Digbot

500

What all comes in the newborn care kit? 

Newborn Care Kit:

  • 0 to 6 months of age:
  • 1 newborn kit per birth

    • Kit includes: diaper bag, diapers, wipes, diaper rash cream, baby blanket, thermometer, bulb syringe