Call Overview/Our Members
What is the title of the short video clip you have watched wherein the advocate is transported to the real situation of the member?
The Headset
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
HIPAA stands for?
Health Insurance Portability and Accountability Act
This is when the advocate connects with another area or department to gather additional information but does not hand off the caller and remove themselves from the call. Instead, the advocate gets the information they need and remains on the call to answer any last minute questions the member may have.
Warm Conference
Under what category in the Call Types would it fall under if the member is calling in and ask "Can I update my address?"
Demographics
Is the phone system used by most advocates to answer and make calls.
OMNI Genesys
Is general information not specific to a single member, but specific to the plan and available to the public (included on sales materials or plan websites).
Basic Plan Information
Are alerts you'll discuss with the member after you address their reason for calling.
NBA
It involves a member threatening to do bodily harm to themselves or others.
One Breath Situations
Is a federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid, the Children's Health Insurance Program (CHIP), and health insurance portability standards.
Centers for Medicare and Medicaid Services (CMS)
Is the main system in which you will access member information, assist callers, and document calls.
Maestro
This is UnitedHealthcare new internal culture movement that is a people-focused commitment to care for the employees so they can care for those we serve.
Make it Matter
Are covered medical services available to our members so they can stay in-check with their health.
Preventive Services
Is there a need to call the member back if the call got disconnected (or member hung up) before they provide a reason for their call?
No
This federal and state-run program provides health insurance to people with low income and certain disabilities.
Medicaid
This tells the system whether you are available to receive calls and helps maintain schedule adherence.
Your status/ aux
It uses AI to summarize member calls, what is it called?
ACD (Auto Call Documentation)
It is a second option available for the member for a colorectal screening in which it can be done in the privacy and convenience of the member's own home.
iFOBT kit
According to Situational Guidelines- Automated Voice System/ IVR, what is the name of the automated voice system for our members?
Avery
What is another name for Medicare Part C?
Medicare Advantage
KC content is divided out by areas or subjects called?
Knowledge Bases
Is extremely important when it comes to meeting our compliance requirements. It is also important so you and other advocates understand when and why a member called.
Documentation
It is the term used to describe the NBAs that populate in Maestro and to describe the offers that populate on a member's account online.
RTO (Real Time Offer)
According to Situational Guidelines- Call Silence, call silence should not be over how many minute?
1 minute/ 60 seconds