CLAIMS CASES
Do we process claims that have already been paid.
What is yes, claims team will work but will not be able to negotiate lower cost.
Where you look to see if member has Onsite Biometric and Flu screenings.
What is HA services in MemPHIS?
The employer or benefits administrator a member has our services through
What is the Organization
Where are we able to make changes to a member's contact information
What is the Demos section of Memphis
If a spouse is calling for member who's name and email is used in case?
What is the member who claims is about.
Member is calling about STD/LTD and FMLA where do we send them?
What is Primary benefits, SAU, NAU and HUB.
If a member stated they are ill and needs to see a primary care provider, who would assist with the search?
What is a Nurse
How many attempts do we make to follow up with a member?
What is 2
What is the name of forms we send to members? What two ways do we send them?
What is Release of Infuriation (ROI's) forms- via email or docusign.
Member calling to make an appointment for screening, where do we do this?
What is go to iClue Member information- Click on appointment tab.
The type of profile for a member we receive for the member
What is a Roster File
We have sent the forms and created Case, how long do we set task for?
What is 4 days.
Can we cancel Biometric appointment same day scheduled?
What is NO, we can't cancel same day as it is closed night before. They can go for walk in but appointments will be taken first.
What information about the claim do we need?
Date of Service:
Provider/ Facility name and phone number:
Amount being billed:
Description of services received:
Issue with the bill:
Member is calling about mental health provider and does not have EAP, where do you send them?
What is Behavioral Health Nurse
When a member needs the registration code for enrolling in the Member Engagement Portal, where can this be located?
What is Iclue Organization Details in the member contact detail section