Call Overview
What was the title of the video presentation we watched under Call Overview that allows the advocate to be transported to the situation of the member.
The Headset
This federal and state-run program provides health insurance to people with low income and certain disabilities.
Medicaid
Is a knowledge management system that contains job aids, standard operating procedures (SOPs) and other important documents that help you resolve member calls.
Knowledge Central
A _____, friendly and professional greeting is a great way to start off the call with confidence and build rapport with the caller.
Warm
These are alerts you'll discuss with the member after you address their reason for calling.
NBA/ Next Best Action
The member is calling and needs help in understanding his explanation of benefits. Under what category/ call types would it fall under?
Claims
What is another name for Medicare Part C?
Medicare Advantage
What allows calls to be routed to different areas based on word responses and touch-tone input.
IVR/ Interactive Voice Response
What does the acronym HIPAA stand for?
Health Insurance Portability and Accountability Act
What is the suggested scripting in KC that celebrates member's accomplishments when they have completed a health action or has a scheduled appointment?
That’s great. I’m glad to hear you’re taking an active role in your health care.
It is an internal culture movement aligned to UnitedHealthcare's external brand promise, there for what matters.
Make it matter
Judy is 72 years old. She has diabetes but manages it well. She is active and works with UHC Wellness Coach to reach her health and wellness goals. What line of business from UnitedHealthcare would Judy belong to?
Medicare and Retirement
What is the UHC Phone System specific to M&R?
OMNI Genesys/ Genesys
True or False: We are allowed to disclose general information about the member's account if the caller is not the member.
True
These are covered medical services available to our members so they can stay in-check with their health.
Preventive Services
This line of business is the largest business dedicated to the health and wellbeing needs of senior and other Medicare beneficiaries.
Medicare and Retirement
The federal agency that controls Medicare and Medicaid.
CMS
Is the main system in which you will access member information, assist callers and document calls.
Maestro
Any person who does not have authorization documented on the member’s account and does not fit any of the other caller types listed in the Knowledge Central.
Third Party- Other
There are two colorectal screenings. Name at least one.
Colonoscopy or iFOBT kit
What is the UHG Mission?
To help people live healthier lives and help make the health system work better for everyone.
Is an extra private insurance that would cover and help pay costs under Parts A, B, and sometimes D, and may also offer other benefits.
Medicare Advantage- Part C
This tells the system whether you are available to receive calls and helps maintain schedule adherence.
Your status/ Your Aux state
It is a general information not specific to a single member, but specific to the plan and is available to the public.
Basic Plan Information
This occurs when your blood glucose, also called blood sugar, is too high
Diabetes