Self-Direction
Self-Direction
offers individuals receiving care increased choice and control over their services and supports.
CMS
Content Management Systems
Person receiving care is called
CONSUMER
Agents will use ____ techniques and assist callers to the best of their ability.
What is CRM?
Customer Relationship Management
Participant decides:
When
What (type of care)
Who (cannot be a spouse, parent or someone living in the household
How
EOHHS
Executive Office of Health and Human Services
Intellectual and Developmental Disabilities
Medicaid offers resources to help support people with IDD and their caregivers
a. Purposely disconnecting the call.
b. Being unresponsive to callers.
c. Placing callers on hold for an extensive amount of time without checking back in with them. (Agents should check back in with the caller every 3 minutes)
d. Failing to call the client back when the call drops (exception: call is disconnected by the caller)
e. Update 8/1/24: Calls disconnected by the caller do not require a call back.
What are the 6 subcategory options available?
a. Transition Specific
b. Enrollment Specific
c. Pay Rate Specific
d. Eligibility
e. Program Related
f. Other
Participants
have a selection of choices over the plan of care, the people who provide care and who receives payment.
ILC
Independent Living Counselor
Licensed Home Care Services Agency
Agencies that provide home care services to people who have private insurance or pay out of pocket.
Callers must not be placed on hold for more than __________.
Three minutes.
Agents should check back in with the caller every 3 minutes.
What is the difference between an 'Activity' & 'Case' with some examples
An 'Activity' means...
YOU have taken an action
* Updated Address
* Returned a call
* Opened a case
* Sent an email
A 'Case' means SOMEONE ELSE needs to take an action
* Correct checklist
* Monitor background check result
* Enrollment Specialist or I&A staff needs to contact the Participant.
Representative
An individual may appoint a representative to assist in performing the responsibilities of the employer
**this position is voluntary and not a paid role
OIG
Office of Inspector General
Managed Long Term Care
Health plans providing Medicaid services, sometimes involved in CDPAP/CDS programs.
What are two possible outcomes of staff providing incorrect information to customers?
If CS staff give out incorrect information, they are expected to make an outbound call to the caller within the same day if possible or within one business day at the latest to provide the correct information.
2. Repetitive incorrect information will result in coaching and potentially corrective action.
When replying to an email, what are the steps to follow?
1. Select email
2. Select Reply, Reply All, or Forward
3. Update “From” Field to “z Email Inbox Only – NY CDPAP”
4. Update PPL Category to “NY CDPAP Inquiry”
5. Update PPL Subcategory
g. FI Inquiry
6. Change [Name] and paste reply
7. Attach documents (if applicable)
8. Proofread everything
9. Select Send
Responsibilities include:
Paperwork
Scheduling
Timesheets
SEIU
Service Employees International Union
Program All-Inclusive for Elderly
Medicaid provides comprehensive medical and social services to certain frail, elderly people (participants) still living in the community
What is PPL's expectations when handling a caller using foul/inappropriate language?
n the event a caller is using foul/inappropriate language or tone, CS staff should politely advise the caller that the call is being recorded, and request the caller be respectful, or the call may be disconnected. If the caller continues to use foul language, CS staff should politely remind the caller no less than 3 times that they will disconnect if this behavior continues, before the CSR disconnects.
a. In the event a caller uses discriminatory or threatening language or indicates a desire to harm themselves or others, CS staff should immediately report the event/incident to their supervisor with the caller's phone number, name of the caller, and date/time of the call. CS Staff should advise that this call is being recorded and that they need to disconnect the call immediately.
b. Supervisors will follow the standard operating procedures to document and report discriminatory or threatening language or desire to harm themselves or others per program guidelines.
True/False
You do not need to create an activity for every call
FALSE
You must create an activity for every call.