True or False
Do member's automatically get the extra support wallet benefit?
FALSE
Communication
Controllable
True or False
Is GPS always correct?
FALSE
Can we assist DSNP accounts?
YES
NPS
Net Promoter Score
What needs to be submitted for an existing member to get extra benefit wallet?
SSBCI form filled by provider
System Issues
Non-controllable
What system would we use to check member's Medicaid Level?
Market Prominence or Marx
Can we assist with HIDE/FIDE accounts
NO
PEAS
Paraphrase, Empathize, Appreciate, Summarize
What are the 2 ways new member can self attest?
Online portal and quickbase form
Education
Controllable
What system would we use to check a member's appeal status?
MedHok
Can we assist CSNP account?
YES
RFL
Resources for Living
How many days does it take for process of new member self attestation done on the online portal?
turnaround time 3-4 days
Using Correct KA's
Controllable
If GPS is not working what system can we use to see member's benefit?
Stars Central Portal
Can we assist restricted accounts?
No. Even if we can see some of these accounts, if restricted access notification comes up get member to correct department for assistance.
QUEST
Quality, Understanding, Empathy, Sensitivity, Trust
What department do we contact for a CEC case with status Completed-UTR?
Engagement Hub
Member's Attitude
Can be considered both a controllable and non-controllable.
If you don't have PNC access, how can you assist a member who is calling to make a premium payment?
You can offer IVR self pay system or contact mentor line to assist with PNC payment.
Can we assist with Group plans?
Only for expedited appeals. When it comes to plan benefits get member to to correct member service number.
SSBCI
Special Supplemental Benefits for the Chronically ill