Plan Name
What is Humana's Program Name?
In-Home Health & Well-being Assessment
For ASL and Akorbi virtual visits which platform do we use?
Zoom
What is the purpose of the call for Humana
I’m calling about the <In-home Health and Well-being Assessment>. It’s a
program for <Humana> members that lets you talk with a clinician in the
comfort of your home. They will check your vital signs and reflexes, review
your medical history and medications, and answer any health-related
questions you may have during the visit. We will send a summary of the visit to
your primary doctor. <Humana> wants to make sure that you know that this
does not replace your regular visits with your primary doctor, and there is no
additional cost for this service.
What Plan can we not say Signify Health in the recording line?
United Healthcare House Calls
Which Plans ask to verify DOB
Wellcare and some Centene Plans
Which Dispositions are we not allowed to use?
Member wants to Opt Out of the Program:
Awaiting callback from Member:
Member agreed to participate:
What do we need to verify when updating an Address
DOB
What are the Covid Questions?
● Have you been fully vaccinated?
[YES] Proceed to COVID-19 Screening questions. Refer to talking points
below if the member objects to COVID-19 screening questions because
they are vaccinated.
[NO] Ask the following:
● Have you been exposed to COVID-19 in the last 14 days or had
close contact or been coughed on by a person who may be
showing symptoms or tested positive for COVID-19?
[YES to second question] Do NOT schedule the member for an
In-Home assessment. Proceed to Failed COVID-19 Screening
closing.
● In the last 10 to 14 days, have you or anyone in your household:
● Been diagnosed, tested or placed in quarantine for COVID-19?
● Experienced any COVID-19 symptoms or have been
hospitalized within the past 14 days with COVID-19 related
symptoms? (including fever, chills, new cough, shortness of
breath or breathing difficulties, fatigue, headache, muscle or
body aches, loss of taste or smell, sore throat, congestion, runny
nose, nausea/vomiting, diarrhea, skin changes, change in mental
status/confusion?)
What do we notate when speaking with a 3rd party?
Name and relationship
What is the process for Spanish transfers?
On the left-hand side of your screen in Five 9, click the tab for Transfer.
Type the word “Spanish” in the search option and the Spanish Queue option will appear, you will complete a “Warm transfer” to provide the Spanish speaking representative with the member account info
Then select ‘Initiate Transfer’.
Once the Spanish- speaking MEC answers, introduce yourself and the explain purpose of your call. When the Spanish-speaking MEC is ready for the member, select Complete Transfer and then Leave Conference. DO NOT click ‘End Call’ or the call will drop all parties.
After warm transferring the call to the Spanish-speaking MEC, you will need to disposition in Scheduling App 2.0 with the following: Unscheduled-Member speaks Spanish and Close Member in Scheduling App 2.0.
What is the Program name for IBC PA (Independence Blue Cross)?
Personal Health Visit
What do you put in the provider notes for Akorbi appts for inhome?
Provider Notes: Member request translation (needed language)
Please Call Translation Services 214-865-7716
Press 1 for Spanish, Press 2 for ALL other languages
Client ID:10489
Auth. Code: 87
What is the Technology Assessment?
Thank you for that. Now let’s see if you have the right technology to do this.
Ask questions to assess technology (offer additional explanations as needed):
● Have you ever been on a video call with family, friends or even your
doctor?
○ Do you know what video app you used?
GENERAL OUTBOUND (VIRTUAL) CALL SCRIPT
2
■ only ask if NOT using integrated video for virtual)
■ popular examples include FaceTime, Skype, Facebook
Messenger, Zoom, Google Duo, Teledoc
○ Will someone be available to help you get on the video call?
■ make note if nobody will be available on appointment
day
● Are you going to be using a laptop, tablet or smartphone with internet
access to complete the virtual appointment?
○ may need to explain what a smartphone is - does it flip open or
is it flat with a touch screen?
○ reliable internet connection is required
○ device must have camera enabled
○ Apple/iOS - use Safari or Google Chrome browser
○ Android/PC - use Google Chrome browser
What is the privacy statement for Wellcare?
Required in Greeting:Any information you share is kept private. You do not have to share any health-related information. Anything you share will not affect membership in your <HEALTH PLAN>
What do we do if an address is invalid?
MECs will see a new enhancement on the
Scheduling App 2.0 in which a nearby address can be added when the member’s actual
address can not be validated. When an address shows as invalid, MECs will follow the
same process of searching for a nearby address. However, MECs will now select the
option to ‘add a nearby address’ and will type the nearby location into the pop-up box
rather than changing the member’s address. Once saved, both the nearby address and
the member’s actual address will be saved on their profile. MECs will no longer need to
leave any notes about the actual address, as providers will be able to see both on their
end.
What dispositions affect conversion rate?
Unscheduled: Member want to opt out? Member agreed to participate
Member Hung up
member request call back
member speaks spanish
What do we do if a provider is calling in?
Transfer to Network support EXT 7510 option #2
What is the additional statement for text and legal reminders when either one opts in?
ONE]Emails and text messages are
not encrypted or secure and can be seen by any third party with access to your
messages. Emails and text messages may contain private health information
such as your name and appointment time.
What is the disposition when the health plan does not allow us to schedule?
Do not schedule per plan: Used when the Health Plan does not allow the Member the opportunity to participate in the program.
What are unacceptable locations for a Visit?
public library
health clinic
nursing home long term
cruise ships
on vacation/ in a vacation location
mobile unit (Ambulance)
Away for the winter/winter home
What does CDPHP stand for?
Capital District Physicians Health Plan
What is the procedure for requesting a summary request?
What is the additional call closing for callbacks?
<MEMBER NAME>, is there a better time to reach you?
Make note of the member’s response in the appropriate notes section.
Before you go, I’d like to make sure we have the correct contact information
on file to send you additional information. Is that okay?
GENERAL OUTBOUND (IN-HOME) CALL SCRIPT
Pink text = customized for client
Blue text = variable fields in call
Red text = Non-spoken procedures and instructions for MECs
Green text= Member responses 7
[YES] Capture communications consent and continue the call
[NO] If member does not consent, Mark "Decline SMS" and check
Email Opt-Out box. Proceed to verify that phone and email are correct.
I see that the phone number we have on file is <MEMBER PHONE>. Is this your
cell phone number?
Verify or collect cell phone and continue with call
[TEXT MESSAGE LEGAL] By providing your cell phone number to us, you agree
to receive text messages from Signify Health and <HEALTH PLAN>. You can
opt-out at any time by replying STOP to any text message. Standard message
and data rates may apply.
The email address I have on file is <MEMBER EMAIL>. Is that the best email to
use? -OR- What is your email address?
Verify or collect email address and continue with call
[EMAIL LEGAL] By providing your email address, you agree to receive emails
from Signify Health and <HEALTH PLAN>. You can unsubscribe at any time.
Emails and text messages are not encrypted or secure and can be seen by any
third party with access to your messages. Emails and text messages may
contain private health information such as your name and appointment time.
Thank you for your time. We look forward to speaking with you in the future.
Have a great day!
What is the Purpose of the Call for IBC
I’m calling to schedule your <INDEPENDENCE BLUE CROSS> <Personal Health
Visit>. It’s a program for <INDEPENDENCE BLUE CROSS> members that lets
you talk with a clinician in the comfort of your home. They will check your vital
signs and reflexes, review your medical history and medications, and answer
any health-related questions you may have during the visit. If you have a
family member who helps to manage your health, they are welcome to attend.
Once the assessment is complete a summary of the visit will be sent to both
you and your primary care physician. This does not replace your regular visits
with your primary doctor and there is no additional cost for this service.
What is the Escalation Process?
Job Aide