This protocol is to assure that cases that have completed the enrollment process through the Enrollment Department are correctly dated and transferred at the enrollment’s completion.
What is PR 117?
100
This person came in with the first class of HOS as Lead.
Who is Keea Turner?
100
In reading the questions for the SF-8 associates are to read the questions in this fashion.
What is verbatim?
100
This service is available when speaking to members who do not use English as their primary language.
What is Cyracom/language line?
100
It is here that an HOS can quickly view a member's condition and program.
What is member summary?
200
The background and scope of this protocol provides the associate with the guidelines to to complete an outbound enrollment call.
What is PR 115?
200
This person was the manager for the Spanish HOS team and the other, manager in Denver.
Who is Ronald Jones and Monica Miles-Wood?
200
The questionnaire is used to update risk levels for low risk CC mbrs.
What is management questionnaire?
200
This 5 letter acronym stands for what requires the company to verify the identity of members in order to disclose PHI. Give the formal name of the acronym.
What is the Health Insurance Portability and Accountability Act?
200
The Questionnaire Center can be found in either of these 3 sections in HRS.
What is 1. clinical info 2. quick links 3. sitemap
300
The backbround and scope of this protocol reads "The SF-8 is a tool used to gain understanding of an adult's functional status and emotional well-being.
What is PR 185?
300
This person is the Director of the Enrollment Team whom Monica and Ron report to.
Who is Tessa Golsch?
300
This program CANNOT be reopened after 90 days?
What is Complex Care?
300
Should a member not want to add anyone to their non member permissions the HE must still complete this documentation action.
What is verification?
300
This tab in HRS can be used to see all tabs and their drop downs in one screen.
What is sitemap?
400
The background and scope of this protocol was created as a guideline for the associate to follow to create a case for a registered member in HRS, if the member is found; but does not have an assigned case number.
What is PR 180?
400
This person is the Staff VP of Disease Management.
Who is Susan Toms?
400
This transfer point is used for Verizon IHM clients upon successful enrollment?
What is IHM Verizon RN ConditionCare?
400
Per PR 130, when updating provider information the associate is to ask for these 3 items about the health care provider.
What is 1. Provider's first and last name 2. city/state 3. phone number
400
When a CC member has a low risk core condition preventing them from participating the HOS would follow this basic 2 step navigation path to update risk levels.
What is 1. Questionnaire Center 2. Management Assessment
500
This protocol outlines the process for managing inbound low risk calls. Outreach is not typically initiated to Low Risk members. However, Low Risk members are welcome to call in and request to speak to a Nurse Coach (NC) or Health Professional (HP), or Heath Educator (HE).
What is PR 135?
500
They are the newest addition to the Enrollment Team.
Who is Jose, Sabrina, Kevin, Anita, Nanette?
500
In the event we are outreaching for a member under age 18; what documentation should occur?
What is Starred Notes?
500
If we do not provide the mbr with the call disclaimer, quality follows-up with this process.
What is risk report?
500
If a case in HRS is mistakingly opened it is considered this contact type.