GAP IN CARE
HRA
QUOTING BENEFITS
WHICH S.O.P IS IT
RANDOM
100
WHAT IS THE GREEN FONT?
UP TO DATE
100
WHAT DOES HRA STAND FOR?
HEALTH RISK ASSESSMENT
100
WHERE DO YOU FIND THE BENEFITS ON FACETS?
BENEFITS SUMMARY
100
WHICH S.O.P. DO YOU USE FOR QUOTING BENEFITS?
CNS CCP QUOTING BENEFITS, BENEFIT LIMITS, AND LIMIT EXPECTATIONS S.O.P.
100
HOW MANY KIDS DOES GLORIA HAVE?
2
200
WHAT IS THE BLACK FONT?
member needs to complete a preventive health service and the gap has not been previously discussed with the member.
200
HOW MANY HRA's DOES LOUISIANA HAVE?
2
200
WHAT IS SICK OFFICE VISIT?
PATIENT GOES FOR ANY REASON (FLU, FOLLOW UPS, ETC.)
200
WHICH S.O.P DO YOU USE TO FIND GAPS IN CARE?
ADVOCATE PROACTIVE MEMBER ENGAGMENT
200
WHAT ARE TRIGGER WORDS FOR MATERNITY?
Pregnancy, labor and delivery, abortion, miscarriages, contraception, etc.
300
WHAT IS THE RED FONT?
indicates that member is not currently active in CSP facets.
300
WHAT SOURCE DO YOU USE?
MEMBER ADVANCED SEARCH I-CUE
300
WHAT IS PREVENTATIVE?
SCREENING AND CHECK UPS (ANNUAL PAP SMEARS, ROUTINE PHYSICAL, ETC.)
300
WHICH S.O.P DO YOU USE TO FIND HRA?
I-CUE ONE SOURCE
300
WHAT IS THE TURN AROUND TIME FOR COORDINATION OF BENEFITS?
3-5 DAYS
400
WHAT IS THE BLUE FONT?
gap in care has been discussed with the member.
400
WHAT ARE THE HRA's THAT LOUISIANA COVERS?
2018 C&S ADULT/PEDIATRIC HEALTH RISK ASSESSMENT
400
WHAT DOES DME STAND FOR?
DURABLE MEDICAL EQUIPMENT
400
WHICH S.O.P. DO YOU USE TO FIND ANOTHER PCP FOR THE MEMBER?
CSP PROVIDER LOOKUP
400
WHAT IS TELEPERFORMANCE CORE VALUES?
INTEGRITY, RESPECT, PROFESSIONALISM, INNOVATION, COMMITMENT
500
WHERE DO YOU FIND THE GAPS IN CARE?
UNIVERSAL TRACKING DATABASE (UTD)
500
AFTER BRINGING UP THE NEEDED SOURCE, WHICH OPTION DO YOU CHOOSE?
#20 INITIATE ENGAGMENT INTAKE
500
WHAT TWO OPTIONS DOES INPATIENT HAVE?
ROOM AND BOARD, AUXILIARY
500
WHERE DO YOU FIND S.O.P.'s?
KNOWLEDGE CENTRAL
500
WHAT IS UNITED HEALTH CARES CORE VALUES?
INNOVATION, RELATIONSHIPS, COMPASSION, INTEGRITY, PERFORMANCE