IPA
Which statement is true for IPA-affiliated members who need to visit a hospital?
They can only visit hospitals affiliated with the IPA except in emergency situations.
MES
Name 3 out of the main call types you will receive in member solutions?
Escalations, Veteran, Bariatrics, Behavioral health, Gender reassignment, IPA and MES
Who founded McDonald’s?
Ray Kroc
While The Simpsons is the longest-running cartoon in the US, what cartoon is the second-longest running?
South Park
Which statement is true about how a member becomes affiliated with an IPA?
They select a primary care provider (PCP) that’s part of an IPA.
True or False? Member needs a referral for to provider under a Med sup plan?
False: med sup is open network as long as provider accepts original Medicare assignment member has no restrictions.
What is the name of the tool used for submitting feedback for a cold transfer?
Coaching Feed back
What is the largest fast food chain in the world?
Subway
Who is Spongebob’s friend that lives under a rock?
Patrick
Which statement is true about providers and IPAs?
Providers who belong to an IPA independently own and operate their own medical offices.
What other plan must be purchased when member has a Med sup plan to pay for drug costs?
Prescription Drug plan.
All escalated calls have this logging process in common.
Escalated call Tracker
In which city was the first KFC restaurant opened?
Salt Lake City, Utah
Who is the brother of Mufasa in the Lion King?
Scar
What is an IPA?
A group of providers who form a group for the purpose health care services and health care management
True of False?
Humana has a Plan F PPO
False!
Where do you navigate to locate user ID and direct leader info?
Master roster RCC
Which fast food restaurant introduced drive-thru service first?
Wendy's
Who is the prince of all Saiyan's
Vegeta
An IPA-affiliated member calls you and asks if they can see a cardiac specialist, Dr. Thomas Williams. He’s in the member’s affiliated IPA. How should you advise the member?
The member should speak with their PCP to ensure that the IPA uses the specialist to service the member’s specific medical need.
What are the 3 states with unique plan names?
Massachusetts, Minnesota and Wisconsin
In the event you were to receive a call where a caller is displaying any derogatory or harmful language or behavior that is directed at an associate personally.
where would you warm transfer the caller?
Abusive Caller Member Solutions Team
Which fast food chain first introduced pizza to its menu?
Domino’s Pizza
What is Garfield's favorite food?
Lasagna