Creating a Call Log
What option will save contact information from one call to the next, or when making changes to the customer type?
Copy Contact for Next Call
When are we required to quote and/or document eligibility?
Every call except for claims only calls.
How many pieces of information do we need to validate for a provider calling?
3
What are privacy authorizations?
Privacy authorizations allow members to grant another person to access protected health information (PHI). Some releases are voluntary, and some may be court ordered.
What famous magician died on Halloween?
Harry Houdini in 1926
What is the Customer Service Inquiry tab used for?
Used to show your call records.
What subject and category do we use when documenting current eligibility?
Subject: Eligibility
Category: Plan Eligibility
What is another piece of information we could ask for if the member doesn't have their ID number?
Phone number, group number, group name, last 4 of SSN as a last resort only.
How many types of confidential communications are there? What are they?
4: MREQ, MINR, CORT, and CORA.
Where did Halloween originate?
Ireland
Yes, we can search for them using last name and DOB.
What 4 pieces of information are required to click note when documenting eligbility?
Eligibility Status, Effective Date, Coverage Type, and Network
When is it a requirement to HIPAA validate?
Prior to entering a member's policy.
What form does a member need to fill out in order to grant a general release of PHI?
The Authorization to Use/Disclose PHI form
How long ago did Halloween originate?
Roughly 2,000 years ago
What information do we need to get from every caller when filling out contact information?
Name, call back number, and if it is a provider what office they are calling from.
What do we need to change in order to find the original effective date?
We must change the beginning date range view back to 01/01/1920.
How many pieces of information do we need to validate for a member calling?
4
How do you check if a general release of PHI is with or without restrictions?
Go to transfer, then member authorization, then select the current entry.
How many pounds of candy is purchased for Halloween?
23.5 million pounds (in 2022)
What customer type should you select if talking about someone who does not have a policy with PacificSource?
Non Member
What is the appropriate subject and category to use when documenting that a member never had coverage?
Subject: Eligibility
Category: NUC
What resource can you reference if you aren't sure what information you're allowed to provide a caller?
The Confidentiality Matrix
What must you do when receiving a verbal authorization?
When receiving verbal authorization, you must also validate the member by asking them for their full name and one additional piece of information, this must be documented in the Validation Box in Facets.
On average, how many seeds are in a pumpkin?
500