Member 1
Member 2
Member 3
100

Precertification Denial

Empathize members concern

Education on precertification status

Education on appeal rights

100

Non emergency transport

Empathize members concerns

Advise on the benefits details

Educate members on transport details / scheduling

100

Member Portal

Empathize members concerns

Assist with member concern to best of your abilities

200

Durable Medical Equipment

Empathize members concern

Educate on members benefit

Advocate for the member in obtaining equipment





200

Prescription Coverage

Empathize the members concerns

Educate member about getting them to the correct department if Part D medication



200

Grievance

Empathize members concerns

Education on process

Explain members grievance rights

300

Address Change

Empathize members concern

Educate on process


300

Claim Denial

Empathize members concerns

Education on claim status

Education on appeal rights

300

Diabetes Equipment

Empathize members concerns

Education on how to obtain equipment 

Advocate for member in making process as easy as possible

400

Enrollment

Empathize members concern

Education on enrollment workflow

400

Provider Directory

Empathize members concerns

Education on how to obtain / receive provider directory

400

Hearing Aid Reimbursement

Empathize members concerns

Education on all ways to submit for reimbursement