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 Plan name for Wellcare HI?
Ohana
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
What is Atenas Program Name?
Health Home Visit
What is the email for giftcards for Signify health gift cards?
giftcards@signifyhealth.com
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?
If the address contains an abbreviation such as Ave or LN, spell the word out in its entirety to see if Bing GPS accepts the address as valid. Use the suggested address and save.
If the address contains an apartment number or lot number, you may have to remove the apartment/lot number to validate the address. *If this works to validate the address, you must also include the apartment/lot number in the Provider notes.
If Bing API is unable to locate the address, follow these steps:
Look up the nearest business address in Bing Maps. (could be the nearest gas station, post office, restaurant, etc.)
Populate nearest business address and Update Member Profile again to validate and remove the error
Document member’s actual address in the provider notes as well as specific instructions on how to reach the residence.
write this exact phase so our providers can see: ALTERNATE LANDMARK ADDRESS USED TO SCHEDULE APPOINTMENT. MEMBER'S ACTUAL HOME ADDRESS IS:
What is the Plan Name for Centene of IN?
Wellcare by Allwell
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