Processes
The two main forms of PHI we want to verify within the first 2 mins of every call.
What is DOB and Full mailing address.
The eligibility screen is the ___ step of the full disability screening process.
The First
This is the response when a concerned member asks "How did you get my info?"
What is advise that the health plan has contracted us to help reach out to members to see if they may qualify for additional benefits.
This is where you will click to begin the eligibility screen
What is the task box
This is the status you will go into when you are having internet connection issues.
What is technical difficulty.
The next step when a member does pass the eligibility screening.
What is Transfer to SOS
During the screening, the member tells you they are currently receiving SSD of $845 and want to know if they could still qualify for SSI.
What is no, the maximum benefit amount is $841. Would need to give consultative talking points.
This is a response to a member who only speaks Arabic.
Apologize and explain to the member that we’ll have someone call them back.
The account note should always be placed here.
What is primary contact
These are the type of calls an OS will receive daily.
What is outbound & inbound calls.
After writing your notations, this tab will ensure it saved onto the member profile.
What is the History tab
You should never imply this to a member regarding their eligibility.
What is implying they DO qualify. Promising they will get accepted.
This is the response for an irate member that asks that you not call them anymore.
What is politely apologize and advise you will place them on the DNC list.
This step will ensure your answers for the application is saved.
What is click next
What type of call back is scheduled through LV.
What is OS.
This method is used to communicate PAUSE/RESUME transfers to SOS
In regards to the eligibility screening, this is how you should respond to a member that advises you they're impairment is a rash and will last 12 months.
What is asking the member if that impairment limits their ability to work. If yes, continue the screening as we must go by what the member says. If no, you will end the screening & give consultative talking points.
This is the service we are offering our members and the reason they should cooperate with our screening.
What is we assist the member with the application process and submit it on their behalf. If approved, the benefit can add up to $841 to their household income.
These are the steps you take when a member advises they would like to get another letter in the mail.
What is correspondence library, type in OUT, and choose correct packet.
This will be the dispo for a robo call.
What is dead air.
This is where the "opt in" warning sign will be if a member needs to verbally OPT IN.
What is top of the summary page.
This should be done for a member that does NOT have an official diagnosis.
What is advise the member that an official diagnosis is not required to determine eligibility. Social security is more concerned with their symptoms! Our disability experts will go over their symptoms with them to see if they meet the requirements for the program.
This is the response you will tell the member when they state that their health plan told them we are a scam.
What is apologize to the member for receiving misinformation from the health plan & request the name of the supervisor they spoke to. Ask the member if we can resend the letter.
What is Reengage
This would be your LV dispo if the members wife answers and advises to be put on DNC list.
What is no message left or left message with person