Eyemed
AEP 2027
Repeat Call Handling
SRT Call Handling
Dental
100

what tools can we use for Eyemed call handling?

What is KA 4528 and AHA Wiki

100

What does "Mind Your P.E.A.S." stand for?

What is Paraphrase, Empathize, Appreciate and Summarize. 

100

Metric that is affected by a repeat caller?

What is ACCAT FCR.

100

When will SRT phone number sunset?

What is 9/15/26

100

Where can you find a denial reason for a dental claim?

What is HRP, in claim under exceptions tab. 

200

What is the maximum reimbursement for an eye refractive exam? 

What is $50. 

200

How many visits can a member get through Signify’s existing Healthy Home Visit (HHV)?

What is This benefit allows for up to two clinically necessary follow up visits per member per year when additional evaluation or intervention is warranted following an initial HHV. 

200

How can we ensure we've answered all members questions?

What is paraphrasing and Summarizing. 

200

When will we stop contacting PBM?

What is 10/19/26

200
Where can we confirm dental codes covered?

What is the EOC and ADA code listing in Epolicies. 

300

What website do we use to find INN Eyemed providers?

300

What happens when members who opted for digital communications don't open their ANOC?

What is Individual members will receive a second reminder email notification in late September. Individual members who do not open their second email notification will receive a printed ANOC document in October. For dates on email or print delivery, please review the MP notes section in GPS.  

300

What can we do if members issue isn't resolved first call?

what is KTC. Keep the commitment and call member back when matter is resolved. 
300

When will SRT Lifeline in TEAMS go live?

What is 10/19/26

300

Where can you find a dental coverage determination/ PA

What is the claims tab.

400

How can members submit an OON claims? 

what is Medicare Claim Reimbursement Form GC 1664-6 (Applicable benefit limits apply) or OON Eyemed Reimbursement Form. 

400

How has CMS tightened how SSBCI eligibility is determined for 2027?

What is 3-prong SSBCI Eligibility Requirements

400

How can we keep a high ACCAT FCR %?

What is by using correct SRs. 

400

What systems can we expect to see in 2027?

What is Slack and Five9

400

If a claim doesn't say "PRE-D", where can you confirm if members benefit was applied? 

What is dental accumulators. 

500

What do we do If a member states that EyeMed will not pay for their refraction?

What is escalate and send member ID, to your supervisor.

500

When can we officially discuss an ANOC?

What is October 1.

500

Member indicates they have called before, after validating call, what's the first thing you check?

What is case comments/ call documentation. 

500

What are the top 6 reasons to contact PBM?

What is billing and credits, order reships, ointment and solutions, expedited mail order requests, mail order special dispensing requests and new or updated credit card information. 

500

Where can we confirm dental frequency limits?

What is ADA code listing in Epolicies.