Disability Eligibility Basics
What are the two main roles that work directly with claimants through the Disability Eligibility (FKA Best Benefits) Service Line?
The Disability Specialist, or DS, and the Senior Outreach Specialist, or SOS.
Why is Phase 1 important?
The claim does not move forward to a medical decision until Phase 1 is complete.
What should a Disability Specialist review in Compass before calling a claimant?
The claimant’s information, current phase/tasks, previous notes, and documents when necessary.
For HIPAA Compliance purposes, in addition to the claimant's first and last name (as well as the first and last name of the caller if NOT the claimant), we must also verify these THREE forms of PHI before we can discuss a claimant's case.
Claimant's Date of Birth, Full Mailing Address, and 10 digit phone number.
Which title is generally associated with Social Security Disability Insurance, or SSDI?
Title II.
Phase 1 - Application Verification, Phase 2 - Pending Decision, Phase 3 - Post Decision (Approval or Denial)
These are the two main tasks associated with the Application Verification Phase.
Phone Interview- Application Verification
Consents- Application Verification
Where can a Disability Specialist review previous calls and contact attempts and other notes in Compass?
Case Notes
What must be stated before verifying three pieces of PHI?
FCC Statement (Call is recorded for quality and compliance purposes).
Which title is generally associated with Supplemental Security Income, or SSI?
Title XVI.
What is the Win-Win-Win?
A successful outcome for the claimant (money from the government), the Health Plan client (money from the government), and Centauri (money from the health plan).
What is the main purpose of the Application Verification phase?
To ensure a PI is completed and a 1696 submitted to the FO so we can move on to Phase 2.
Which area of Compass contains documents related to the claimant’s case?
The Documents tab.
You are assisting a claimant with completing the E1696. What will you instruct them to do once they receive their email with the E1696?
Enter the password you made and scroll to the last page and click to sign their name.
What is the max amount someone can get for SSI?
$994/month
What is a 1696 used for?
Representative form so Centauri can assist claimant with their SSI/SSD claim.
If a Phone Interview is completed and a 1696 submitted AND processed by the FO, where does the case go next? What phase and SSA office type?
Phase 2 - Pending Decision and case is at DDS.
Where should the Phone Interview date and time be entered in Compass?
Application Tab under Application Details and Claim Type
We must follow this rule when placing a claimant on hold.
The 3-Minute Rule, meaning we must check back in every 3 minutes
Which claim type can children qualify for?
SSI (Title XVI)
If an adult claimant does not pass their Phone Interview, what is our next step?
Verify to see if SSDI is pending before closing the case
This section in Compass is where you would put dates when validating and faxing a 1696 to the FO.
Documents tab AND Application tab
What is a campaign call?
Auto dialed call
Who are the Centauri EDPNAs?
Victoria O Connell
Matthew Wood
Matthew Garcia
Ashley Bennie