Show:
SEARCH
VERIFY
HISTORY
WORKFLOWS
DOCUMENT AND CLOSE
100
When searching for a member ID- do you need to use the prefix?
What is NO
100
How many boxes need to be checked on the VERIFY screen in order to get the proceed authorized button to appear on a member call
What is 3
100
What is the purpose of the History screen?
What is to see previous calls that were made on this ID number or to see if there are any pending activites for the member in session
100
If someone is calling about eligibility- what workflow will you choose?
What is ELIGIBILITY?
100
What will autodocument for you right now?
What is VOI and Workflow selected
200
When searching for a member by name, can you just enter Smith for last name and J for first name?
What is NO
200
What color is the Avatar if you have not completed the verification process?
What is BLUE
200
Will the history screen show the DCN number that was created when it was pushed to WiseGUI?
What is YES
200
What workflow will you select if a member needs help with MyBlue
What is WEB
200
Name three systems that will come up when you select a Medical Claims Workflow?
What is Claims Summary, Eligibility, Coverage Inquiry, Medical Benefit Matrix, Blue2 for Corelink
300
Other than NPI- what are the other four(4) radio button ways to search for a provider?
What is EIN, PIN, NAME, OOS
300
What color is the Avatar once you are able to proceed as authorized?
What is GREEN
300
How can you access notes on a previous call?
What is CLICKING IN THE WHITE SPACE OR A SPACE ON THE LINE THAT DOES NOT HAVE TEXT IN THE SPACE
300
Is it possible that you will go into multiple workflows just on one call?
What is YES
300
Other than marking complete, what are the other 2 items you can do with your activity?
What is PEND OR ROUTE
400
When you doing an OOS provider call, the search button changes to say _____?
What is ACCEPT
400
What color is the Avatar if you cannot proceed as Authorized?
What is RED
400
When looking at the note, is it displaying all notes or just the notes on the last item?
What is the LAST ITEM
400
In the Other Category, what subcategory will you select if you need to transfer your caller to COB?
What is INTERNAL TRANSFER
400
Name some of the root causes for general claims?
What is Paid, Denied, Correctly, Appeals, 30+ days
500
When you are getting ready to move to the Verify Screen, what should you say to the member to make sure it is OK, to continue on with her policy?
What is Will it be alright if I ask you some more questions?
500
What is the indication that there is a suppression on the member?
What is a STOP SIGN and RED TEXT INDICATING SUPPRESSION IN EFFECT
500
Will the history screen show all of your pended items?
What is NO, it will only show any pended activites for that member that ANYONE has open currently
500
What are the subcategories located under the Provider Workflow Category?
What is PROVIDER LOOK UP AND NAVINET
500
Where do you find pretypes for documentation?
What is Blue Space, Quick References, C.A.T Pretypes