Goodness Rewards
What is the goodness rewards program?
An incentive for members to complete specific health activities.
What is an A1C test/kit used for?
To detect how well a members high blood sugar/diabetes is being managed.
What is the difference between an Annual Wellness Visit and an Annual Physical Exam?
An Annual Wellness Visit focuses on preventative care and health planning, while a physical exam is a hands-on assessment to diagnose and treat existing medical concerns.
What state are all providers going to be located in?
Pennsylvania
What should we disposition if we leave a voicemail?
Left VM
50$ and 10$
What should we not do in regards to the flu vaccine?
We are not helping members find a location or schedule a flu vaccine. We should direct them to their local pharmacy or PCP to find a location.
What is a mammogram?
A mammogram is a low-dose X-ray image of the breast used to screen for or diagnose breast cancer.
What plan should we select when locating a provider?
PA Medicare
What should we disposition if we do not leave a voicemail and no one answers?
No Answer/No VM
What are the rewardable activities?
The Annual Wellness Visit and the HRA (Health Risk Assessment).
What is the FIT Kit used for?
It is an at home lab test from Everlywell, that is used to screen for colon cancer.
What is CBP and why is it important?
CBP is Controlling Blood Pressure, it is important because it is the only way to detect hypertension (High blood pressure).
How should we look-up a provider?
Provider by specialty
You can ONLY use this disposition if you hear the 3 dial tones and the automated message states "the number you are trying to reach is no longer in service".
Is the goodness rewards card a gift card?
No, the goodness rewards card is a rewards card.
Who should members contact for questions or concerns regarding the at home A1C & FIT kits?
They should contact Everlywell at 1-855-923-2678
Why is the HRA important?
Because your health can change over time, and the HRA assessment can help providers/health plans find problems before they become an issue.
What information should we provide to the member when we locate a provider?
The specialty, name of practice, name of provider, address, phone number and office hours if applicable.
What should you disposition if you have completed the call with the member?
Addressed
Where can members find a full list of eligible stores to use their goodness rewards card?
Where can you find the list of phone numbers for different services such as transportation and Everlywell?
You can find a list of all phone numbers in the Highmark Directory.
How do you respond to a member when they tell you that they do not need to complete one of the gaps?
Explain to the member the importance of the gap that they do not want to complete. Try to encourage them to complete each gap.
Do we ask a member for their zip code when looking up a provider?
NO, we should be looking at their chart and collecting the information from there.
What should we disposition if the person we called stated that we have the wrong number?
Wrong Number
What can members use their goodness rewards on?
If a member has questions on what they CAN purchase with their goodness rewards card, we should instruct them to call the Goodness Rewards Customer Service number (Located in the Highmark Directory).
If a member has specific questions about a gap/gaps that we do NOT have an answer for, what should we do?
If a member has specific questions regarding a gap/gaps that we cannot provide an answer for, we should encourage them to speak with their provider.
Name all of the possible gaps members could have open.
AWV, A1C kit, COL Kit (FIT Kit), BCS, FLU, CBP and EED. Also, the HRA can be considered a gap.
What should you do if you experience a technical issue with the provider look-up (for example: the provider look-up is not working)?
You should apologize to the member and explain that you are having a system issue with the website and try again later in the call. Make sure to take note of the appointment that you were unable to schedule.
What should you disposition if the member hangs up at any time before completing the call?
Member requests call back.