Scripting
If a caller asks to receive mail in an alternative format such as braille, audio CDs, or large print what is the scripting that will be stated to the caller? Also, what needs to be done?
We do offer these materials in an alternate format, such as larger print, braille, read-aloud accommodations and electronic communications. Are you interested in any of these options?
An escalation will need to be made in order to have the requested documents sent.
If someone is calling and wants to apply for SNAP, what do you need to do?
Refer and provide then with the enterprise call center number
What are the 4 main pieces of information we use to IDP?
Name, DOB, SS#, and Address
If someone want's to speak to CVIU, what is the number that needs to be provided?
1-833-818-8752
John Tyler called to submit a MA app for his 23 year old daughter who he no longer claims as a tax dependent. Is he allowed to complete the app for her?
Yes, anyone can submit a MA app on the behalf of an applicant.
What is the document number that is used when a translator is needed on a call?
Document 2377
If a member states that they need to complete a new application that the started on 4/28/2024 and it is now 5/1/2024, What needs to be done?
Inform the member a new app will need to be completed due to it being over 24 hours and that app is no longer valid
If a member states they are homeless, what is needed to IDP?
Name, DOB, SS#, and Locality
What is Cover VA phone number?
855-242-8282
Tory Baker who is the AR for Mary Poppins with the duties "Apply for benefits". Are you able to release case specific information to Tory? Things such as who the CW is, and what type of coverage they have?
No, due to the AR limited duties you are not allowed to release case specific information.
What is the scripting for if someone has failed verification?
I'm sorry for the inconvenience. We were unable to access a case. Please reach out to your local department of social services if you have any inquiries about the information on file. Even though we cannot currently access a case, I am happy to provide you with any general information. Do you have any general questions?
What common call types have direct links that will take you to the scripting in PVV?
Add a NB Via Deeming, New App, Renewal App, Report My Change
If someone is calling on the behalf of a member and they are able to provide the members core 4, what else needs to be looked at to see if you are able to speak with them.
See if they are listed as an authorized representative and their duties
If a provider is calling in to check on a claim status, who do they need to contact? What is the number?
DMAS Provider Helpline. 800-552-8627
Tanya Johnson called to check her coverage type. She is the only one listed on the case. She provider her name, dob, and address. A ss# was not provided due to her not having one. Is she able to IDP?
Yes, by her being the only one on the case, we are able to IDP.
What is the scripting when you are unable to transfer a member to another agent?
I apologize but I am unable to transfer you to another agent as we are currently experiencing system difficulties at this time. Please give us a call back in approximately [insert estimated time-frame] at 1-855-242-8282. We are open Monday to Friday from 8 AM to 7 PM, and Saturday from 9 AM to Noon.
If someone calls and states that they need transportation and they have full MA coverage, who do they contact?
If they have full MA coverage, you will look up transportation assistance and locate what MCO they have. Then refer them to the MCO transportation line
Member states their address is 107 South West Ave. Terren, VA 23061. In our system the address shows 107 South West Ave NE. Terren, VA 23061. Can the member pass IDP? Why or why not?
No. The member didnt state the NE portion of the address.
When someone is calling in regards to dental, who do they need to contact? What is the number?
SMILES for Children (888-912-3456)
A Caseworker called on the behalf of a member to get case specific information regarding a member. The CW was able to provide the name, dob, ss#, and address of the member. Are you able to release case specific information?
If the CW is not listed as the AR, you will not be able to speak to them. If you are able to receive verbal consent from the member and they are able to IDP then you can speak.
When a member is calling to cancel their Medicaid coverage, what scripting is used? What is the document #?
Thank you for that information. I would be happy to help you cancel your coverage. In order to cancel existing Medical Assistance coverage, you will need to submit a request directly to your LDSS Case Worker either in writing or verbally over the phone. I can provide you with your caseworker's contact information and instructions for how to submit your request via either method. Which do you prefer?
Document 2068
If someone calls in and states they are needing a 1095 A form, what needs to be done?
They will need to contact Marketplace due to us only generating 1095B forms.
What 7 pieces of information are needed from a provider in order to IDP
Name, NPI Number, Facility name, Member name, dob, ss#, and address
If someone calls and states they have applied for insurance through the Marketplace, who should they contact? What is the number
Health Insurance Marketplace, 888-687-1501
Nyla Johnson a provider from One Life Facility called on the behalf of a member. The provider was able to provide the name, dob, ss#, and address of the member. Are you able to release information to the provider.
No, The provider did not provide the NPI number.