GMS Connect
Greet at the ______
What is : The beep
If you speak with a someone who is not the member and they say "Take me off the list" But you weren't able to verify mbr..
You would disposition as a _______
What is : Do Not Call
(KEEP IN MIND) No matter who you speak with DNC is DNC
When to ask for COHABS ?
What is : All Day Erry day
!! Unless script says NO COHABS !!
What does ACW stand for ?
What is : After Call Work
(KEEP IN MIND) This number should be low on the reports !!
You can Update contact info at any point during the call.
What is : True
(KEEP IN MIND) ITS ALWAYS bottom right of screen !!
Your shift starts at ____
What is : 9 am
You greet at the beep and you ask to speak with "Jeremey Rinehart" the mbr answers with "No im not interested"
You would dispo as _______
What is : Left message
(KEEP IN MIND) you weren't able to verify mbr.
What is the 3 steps to manage resistance ?
What is :
- Acknowledge
- Key statement
- Confirm statement
Mbr states "I already had this visit" What do you do first ?
What is : Check CCA interactions to check if its CHA or GAP visit
When someone new jumps on the line You start the script over.
What is : True
(KEEP IN MIND) You have to mention you're on a recorded line.
Why are we calling ?
What is : Offering quality visits for elderly with their participating health insurance.
(KEEP IN MIND) Refer to FFA
You speak with a caregiver and they adv mbr is in a senior living and they have 24 hr care
You would dispo as ______
What is : LTC (more of hospital environment)
(KEEP IN MIND) SNF is limited care. independent living.
You're on the phone with a member you verify there name and they state "I already have health insurance"
How would you rebuttal
What is : Check cca interactions first then You would let the mbr know this visit is part of matrix and ask if a matrix np was the ones who stopped by.
State that matrix would like to conduct this visit as well.
What are the 5 special instructions ?
What is :
Home instructions // Safety concerns// Health concerns// Pets? // Parking?
You get an APT, The game of the day is spin the wheel. you put yourself in training to save your supervisor the hassle and then you notify your supervisor you got an apt and want to play the game.
What is : False
NOTIFY YOUR SUPERVISOR FIRST
(KEEP IN MIND) you only put yourself in training when your supervisor advices you to do so !!
Who is the HEAD owner of Gms connect ?
Who is : Ed Gonzalez
How do you dispo an admin visit ?
What is :
- Choose random date & Continue script like normal
- Copy special instructions
- Before save an prepare CBR 2days out
- Paste special instructions
Mbr states has question about bill ? How can we assist ?
What is : Offer mbr there health plans customer service phone #
3 Ways to Search for COHABS
What is :
- Name and dob
- Address
- Phone #
Youre on the phone with a mbr and they complain they're still waiting on our approval of medication. You give the mbr our customer service phone #
What is : False
(KEEP IN MIND) You want to offer there health plans phone #
What Does GMS Stand for ?
Gonzo Marketing Systems
You speak with mbr who is hesitant to give any info over phone bc does not believe in partner with health plan.
You would dispo as _____
What is : Not a mbr of plan (fraud)
HIPAA
(KEEP IN MIND) "mbr states ineligible" means mbr no longer is part of health plan.
DIAL WITH A SMILE
How can we take control over these calls when mbr is resistance
What is : Your attitude
when you sound easy to talk to it will make it easier for the member to talk to you and them.
Take control by making them feel understood !!
How to call a mbr back ?
What is : Click blue phone on top right and choose call disconnected or secondary call.
- You can also go into follow up and conduct New call (to the left)
Youre scheduling an apt and mbr states isn't available all day you ask if a 4hour window of 8-12 works.
What is : False
(KEEP IN MIND) To only offer 4 hr window if mbr gives time frame less then 4hrs and you ask "earliest and latest"