GPS
What does GPS stand for
Guided Personal Service
How to view documents MB's send to us
IOP/ ECHS
How old does a MB have to be to get Medicare
65/Under 65 with Certain Disabilities
Who helps you find answers in e.policies
Ask Carmen
What's another way to check if mm completed HRA Survey before contacting Care Team
Medcompass> Assessments
Where can you go to locate a letter we sent to mm
Communications Tab
How to find Broker's information
MP
When is IEP and how long do they have
3 months before their 65th birthday, month of their birthday, and 3 months after their 65th birthday/ 7 months
Where can you find links to many different systems you would use
Wiki Tools
What is LEP and where does that charge come from
Late Enrollment Penalty/ Medicare
Where do you find Medicare ID # and effective dates
Medicare Attributes
How to mail disenrollment form to MB
OBC
Janay Dean is dissatisfied with her plan and wants a new one but she used her SEP to move into this new plan. What do you tell the MB? The date is 11/8/22 Be specific if there is an election they can use
Provide empathy, advise of AEP, trans to telesales.
What company is considered a Joint Venture with Aetna
Allina Health
Makayla George is complaining about how upset she is with a provider and says that she needs the number to Medicare to file a complaint. What do you do?
Provide empathy, advise MB that you can file the grievance for her also offer to find a new provider for her
Can you help someone who is not a MB and not authorized on the account
Yes, you can give level 1 information
How do we find EOC not using GPS
Map tools/Stars
Nenia Applebottom calls in furious because she never knew her insurance was changed and wants to cancel her enrollment. You see that she receives extra help (LIS) Enrollment begins: 05/22/22, the date is 07/15/22
Provide empathy advise MB how to disenroll, file a grievance for MB misrepresentation
Where can you refer members if they do not have certain benefits on their plan that they want access to that are not DSNP
Resources for Living
When can a MM Cancel VS Disenroll?
MM can cancel before plan starts and disenroll after effective date has started
What is needed to authorize account without IVR
Name, DOB, Phone #, Address
Janell Howard is not pulling up in the system. What can you do to find her enrollment
Check Marx
Mona Starr just moved from Alaska to Texas and wants to change her plan. What can she use to change her plan. The date is 12/15/22 Be specific if there is an election they can use
SEP
What is the first thing you say when answering the phone if the call comes in as a 'repeat caller'?
say: ‘I understand you may have called on this issue before, is this correct?”
If mm is calling to file a Grievance for something that happened 6 months ago- Is it still considered a grievance?
No, it would be considered an inquiry