GROUP RETIREE
WHAT MODEL DID WE LEARN ABOUT THAT IS CUSTOM
800 SERIES
QUALITY MEASURE 5, 6, AND 8 ARE ALL WHAT POINT VALUE? AND WHAT IS IT WORTH?
HIGH AND 6 POINTS
TELL ME WHAT THE CALL OUTCOMES ARE IN ORDER
TELEPHONIC ENROLLMENT, FIELD APPOINTMENT, MEETING AND SEND FULFILLMENT
THE SYSTEM WE USE TO VERIFY MEDICARE INFORMATION AND ALSO CAN SEE LIS INFORMATION.
MARX
WHAT RESOURCE CAN I USE TO FIND THE PHONE NUMBER FOR MEDICAID COMMUNITY PLAN?
PHONE NUMBERS ADDRESSES JOB AID IN KNOWLEDGE CENTRAL
WHAT IS THE 3-STEP PROCESS FOR NPPO PROVIDER LOOKUP
CHECK RALLY, HISTORIC, SUBMIT OUTREACH FORM
TRUE OR FALSE: WHEN A CONSUMER IS GIVING ME THEIR MEDICATIONS, I DO NOT HAVE TO CLARIFY THE FORM
FALSE
WHAT IS THE NAME OF THE DRUP LOOKUP FOR INDIVIDUAL CONSUMERS?
DRUG COST ESTIMATOR
GROUP FULFILLMENT PORTAL
THERE ARE CERTAIN SITUATIONS THAT MAY COME UP ON YOUR CALLS THAT YOU LEARNED ABOUT. NAME THREE
ONE BREATH SITUATION, SYSTEM OUTAGE, NON-RESPONSIVE CALLER, ABUSIVE CALLER, ESCALATED CALLS, HOLD GUIDELINES, CALL AVOIDANCE, EMERGENCY SITUATIONS
THIS IS A RESOURCE THAT IS USED TO DETERMINE ELIGIBILITY FOR GROUP RETIREES IF IT IS AVAILABLE
ROSTER FILE
WHAT IS THE DIFFERENCE BETWEEN QUALITY MEASURES AND BASELINE BENEFITS
QUALITY MEASURES ARE MEASURES SET IN PLACE TO MAKE SURE WE ARE MEETING THE NEEDS OF THE CONSUMER EFFICENTLY AND TO MAKE SURE YOU AS THE AGENT IS COMPLIANT AND BASELINE BENEFITS ARE CERTAIN BENEFITS THAT HAS TO BE READ VERBATIM RIGHT BEFORE YOU COMPLETE AN ENROLLMENT
WHY IS IT SO IMPORTANT TO GATHER A THOROUGH NEEDS DIALOGUE?
TO MATCH THEIR NEEDS TO THE SOLUTION
WHAT IS ARE MAIN SYSTEM FOR GATHERING DEMOGRAPHICS AND LOOKING UP PLANS FOR INDIVIDUAL CONSUMERS
BCONNECTED
IF YOU ARE SUBMITTING AN OUTREACH FORM AND IT IS 25 DAYS PRIOR TO THE RETIREE EFFECTIVE DATE, WHAT WOULD THE PRIORITY BE SET AS?
HIGH PRIORITY- 0-30 DAYS PRIOR TO EFFECTIVE DATE *ALWAYS USE YOUR JOB AID*
IF YOU ARE NOT ABLE TO LOCATE A EMPLOYER GROUP IN THE EMPLOYER GROUP FOLDERS, WHAT RESOURCE THEN LOOK IN
EMPLOYER GROUP MASTER TFN LIST
WHAT IS THE MINIMUM SCORE YOU HAVE TO HAVE TO PASS QUALITY?
96%
TRUE OR FALSE: A WITNESS CAN GO THROUGH THE WHOLE CALL WITHOUT THE APPLICANT COMING ON?
FALSE
WHAT IS THE NAME OF THE JOB AID THAT WE USE TO LOOKUP HEARING PACKAGES INFORMATION FOR GROUP RETIREES
WELLNESS PROGRAMS AND ANCILLARY BENEFITS JOB AID
IF YOU ARE LOOKING UP A PERSON PROVIDER AND YOU SEE THAT THEIR DOCTOR IS NOT IN NETWORK. WHAT WOULD YOU INFORM THEM FOR HMO AND PPO
FOR HMO-OFFER TO LOOKUP ANOTHER PROVIDER FOR THEM, PROVIDER HAS TO BE LISTED.
FOR PPO-OFFER TO LOOKUP PROVIDER IF NOT EDUCATE THEM FOR THEIR PROVIDER BEING OUT OF NETWORK AND USE JOB AID TO GET THE PCP ID NUMBER
WHICH TAB WITHIN THE TOOLKIT WILL GIVE THE INFORMATION ABOUT THE OPT-OUT PROCESS?
ENROLLMENT TAB
HOW MANY QUALITY MEASURES ARE THERE?
34 TOTAL
WHAT JOB AID CAN WE CHECK IF WE ARE UNSURE OF THE DOSAGE FORM?
MEDICATION DOSAGE FORM AND ABBV. JOB AID
WHAT IS THE NAME OF THE JOB AID THAT YOU WOULD USE TO QUOTE COST FOR CONSUMER THAT ARE RECEIVING LIS?
EXTRA HELP CALL HANDLING TOOL JOB AID
WHAT INFORMATION MUST YOU OBTAIN PRIOR TO RELEASING ANY PERSONAL INFORMATION
FIRST AND LAST NAME AND DOB (HIPAA)