Day 2 - Review

A

100

TRUE or FALSE. Sympathy is a response that acknowledges the other person’s situation but doesn’t consider it from their point of view. 

True

200

What is Empathy?

Empathy is the ability to affirm customer's feelings and indicate that you can understand their emotions.

300

TRUE or FALSE. Mobile payments are regulated transactions that take place digitally through the member's bank account.

FALSE.

Mobile payments are regulated transactions that take place digitally through the member's mobile device. 

400

Give at least 5 examples of Payment Methods.

- Checks

- Debit Card

- Credit Card

- Mobile Payments

- RailRoad Retirement Board Checks

- Bill Pay

- Money Order

- SS Checks

- Electronic Bank Transfers

500

Give at least 5 examples of a Facility.

• Hospital

• Skilled Nursing Facility

• Home Health Agency

• Outpatient Physical Therapy

• Hospice

• Laboratory

• Supplier

B

100

True or False. Provider is an individual health professional or a health facility organization licensed to provide health care diagnosis and treatment services including medication, surgery and medical devices.

True.

200

TRUE or FALSE. Medicaid is a national program that subsidizes healthcare services for anyone age 65 or older, younger people with specific eligibility criteria, and people with certain diseases.  

Medicaid

- is a joint federal and state program that provides health care coverage to low-income individuals.

300

What is a Over-The-Counter?

OTC

- Medicines that do not require a prescription.  

400

What are the 2 types of IN-Network Pharmacies?

Standard and Preferred Pharmacies

500

TRUE or FALSE. Mary is calling in behalf of her grandfather. Mary is not listed as an Unauthorized Person. What does she can do to proceed to pull up the account?

Verbal Authorization

C

100

Lydia called due to a member went in their Pharmacy yesterday and asked if they can do a prescription to transfer one of his drugs. His previous pharmacy is already closed, and he would like to get his medications from our pharmacy. Who is this caller?

Pharmacist

200

YES or NO. Miya called in asking if we can help her change her email address on file. Can we help her?

Yes.

300

Yes or No. David called in to seek assistance to add additional plan on his insurance. Can we help him?

Yes.

400

Give at least 4 other callers.

- POA

- SHIPP Counselor

- Family Member

- Broker/Agents

- Internal Callers

- Pharmacist

- Benefit Verification Specialist-

500

Give at least 4 Common Call Types.

- Change Email Address and Phone Number

- Requests for Materials

- Premium Payments

- Eligibility

- Plan Change

- Billing Inquiry

- Drug Copay

- Claim Rejection