Rebuttals
Two rebuttals
What is how many rebuttals do you give before closing the call?
You need a translator, but there's not one available for the language you need, so you will disposition the call as
What is Dispo 37?
Name and date of birth
What is the proper way to verify a member?
Hi, my name is _______ calling on behalf of United Healthcare Community plan of NY, calling for
What is your call introduction?
You will need this many days in advance when scheduling transportation for a member.
What is 3 days?
This is United Healthcare Community plan of NY. I understand that these calls are prominent right now but we are indeed your insurance plan. You can call and speak to our inbound team if that makes you more comfortable.
What is what you say when asked if the call is a scam?
The member states they already had their appointment/their appointment is already scheduled for the AWV, so you will
Name and address
What is acceptable verification when a member refuses to verify?
This call may be monitored or recorded for quality assurance and training purposes?
What is what must be read at the beginning of every call and every transfer to someone new?
Kidney Health Eval, Controlling High BP, and Diabetes A1C
Which GAPS are included with the AWV?
Ok, great. Since we're already on the phone together, do you mind if we call the office together now and schedule the appointment? This will only take a couple of minutes and you will be speaking with your PCP.
What is the rebuttal you use when the member states they will make their own appointment?
What is disposition 10?
Their name, the member's name, and the member's date of birth
Any verbiage in red and white
What must be read verbatim?
If the clinic is walk-in and the member provides the date and time they will go, you will disposition the call as ______
What is dispo 10 - Appointment scheduled
A member is cussing you out, and you advised the member to refrain from using that language or you will have to disconnect. The member doesn't stop so you will
What is advise the member you are disconnecting the call due to their language and provide the call closing?
You already advised the member you were disconnecting the call due to their foul language, and you provided the call closing and disconnected, so now you will
What is get permission from your supervisor to dispo the call as dispo 35?
We do not have to call member services to confirm the authorized rep when ______ .
What is the authorized rep is listed and verifies the member's name and DOB?
Thank you, I also want to confirm whether your office makes appointment reminder calls, as well as do they need to bring anything to the appointment. Once again, thank you, I appreciate your assistance and time today. Goodby
What is the provider call closing?
The zip code
What is what you enter when looking for a PCP closest to the member?
This is a courtesy call on behalf of United Healthcare. I'm calling with some important health information. Is now a good time to talk?
What is what you say when the member wants to know what the call is about before they are verified?
When hung up on, we never use disposition ______ . The correct disposition is ______ .
What is dispo 34 and 52?
Thank you for taking the time to speak with me today. I would like to clarify that you do not wish to continue our conversation. Is this correct? On behalf of United Healthcare of NY, thank you again for speaking to me today.
What is what you say if the member refuses to verify at all?
I do apologize, I do not have that information, but I am more than happy to warm transfer you to member services so they can assist
What is when the member has general questions, needs to update any information (including PCP change) or needs an ID card?
The member needs assistance with scheduling an appointment with a specialist, so you will
What is warm transfer the member to member services?