Processes
This method is used to communicate PAUSE/RESUME transfers to SOS
What is EMAIL
Eligibility screen is the __ step of the full Disability Screening process.
What is FIRST
This is the response when a concerned member asks "How did you get my info??"
What is Advise their health plan has contracted us to reach out to their members they feel may qualify for benefits
This is where you will click to begin Eligibility Screening.
What is the TASKS box
You can always speak with a member's spouse.
What is NO, you must get member's verbal consent or the member must be physically unable to communicate
This must be given within the first minute of every call.
What is the recorded call disclosure?
During screening, the member tells you they are currently receiving SSD and want to know if they could still qualify for SSI.
What is YES, they could still qualify for the combined income of SSI up to $794.
This is the most important element to ensure the member and Call Miner can understand you.
What is speaking in a clear, even paced tone
The account note should always be placed here.
What is the Primary Contact
Outreach Specialist: "Do you work full time earning more than $X per month?"
What is NO, should be two separate questions
The two main forms of PHI we want to verify within the first 2 minutes of every call.
What is the DOB and Full Address?
You should never imply this to a member regarding their eligibility.
What is implying they DO qualify for benefits
MAY qualify
POTENTIALLY qualify
This is the procedure for an irate member asks that you do not call them anymore.
What is politely apologize and advise you will place them on the Do Not Call list
After marking the Eligibility Screening as COMPLETED, you should then press this instead of 'next'.
What is Go To Summary Page
If a member hangs up on us on purpose, we will try to call them back at another time.
What is NO, we will only call back if there are obvious technical issues. If a member hangs up, they are placed on DNC list
The next step when a member DOES pass the Eligibility Screening
What is Transfer to an SOS to complete the screening?
In regards to the eligibility screening, this is how you should respond to a member that advises you they only have a rash and it will last at least 12 months.
What is Continue the screening, we must go by what member says.
SOS will determine further eligibility
This is the service we are offering our members and the reason they should cooperate with our screening.
What is we assist the member with the application process and submit on their behalf
For transfers and scheduled call backs, this is who you will change the account owner to.
Who is Judy Schraft?
You should continue with the eligibility screening if the member has a pending SSI application.
What is "Yes, if they would like our assistance and don't have an attorney or other rep"
This tab, in Compass, is where the "Opt In" documentation will be housed (if necessary)
What is the Correspondence Library
This should be done for a member that does NOT have an official diagnosis yet.
What is advise a diagnosis is NOT required to determine eligibility.
This is what you would advise a member who has disenrolled from their health plan
What is we are contracted by many health plans and can still proceed (advise SOS and notate)
When scheduling an SOS callback, the HP Referral Priority must be set to this.
What is Reengage
You should stop the screening process if you discover the member representative you are speaking to is the child's step-parent instead of parent.
What is "Stop the screening and ask if they have guardianship/custody through the courts. If they do you can proceed"