Appt. Availability
In CSI, Provider Outreach is found under this toolbar menu.
What is the Communication dropdown?
Centene Vision Services supports this initiative by encouraging or scheduling diabetic eye exams for eligible members.
What is HEDIS?
This call result is used after a representative successfully schedules an eye exam and provides the member with the appointment details.
What is "Member Appt Scheduled"?
These three letters identify information that must be protected because it relates to a person's health.
What is PHI?
Octopuses have three of these organs
What are hearts?
Appointment Availability calls apply only to this line of business.
What is the Medicaid line of business?
Under the HEDIS initiative, Centene Vision Services focuses on scheduling eye exams for members in this age range with Type 1 or Type 2 diabetes.
What is ages 18–75?
A member declines scheduling assistance even after the representative explains the importance of the exam and available benefits. This call result should be selected.
What is "Member Refused"?
This application houses Provider Outreach and HEDIS Outreach projects.
What is CSI (Customer Service Interface)?
This Flying mammal uses radar to "see".
What is a bat?
After completing all required questions, agents select this option to move to the next provider.
What is "End Call"?
efore calling a member, agents must first verify this to determine if outreach should continue.
What is whether the member's health plan is active?
A member prefers to schedule their own appointment or already has one scheduled for a future date. Which call result applies?
What is "Member States Will Schedule/Has Scheduled Appointment"?
Health plans may have different requirements outlined by this agreement for routine and urgent appointments.
What is an SLA (Service Level Agreement)?
Crickets have their hearing organs here.
What are their knees?
These provider types are excluded from Appointment Availability standards because they do not provide General Dentistry services.
What are specialty providers (such as Orthodontics Only, Oral Surgery Only, Endodontics Only, Periodontics Only, Prosthodontics Only, Nursing Homes, Mobile Units, School-Based Outreach, and Anesthesia Only)?
After completing the call, agents must choose this from the dropdown menu.
What is the call result?
The representative cannot communicate with the member because they speak another language and future outreach will use Language Line.
What is "Member Speaks Foreign Language"?
This acronym stands for Healthcare Effectiveness Data & Information Set.
What is HEDIS?
This feline is the national animal of India.
What is a Bengel Tiger?
Health plans may have different requirements for these four appointment categories.
What are routine appointments, urgent appointments, existing patients, and new patients?
If a better phone number is found in CSI, agents should record it in this section of the HEDIS application.
What is the comments section?
This call result is used if the member is deceased, no longer covered by the health plan, or has prosthetics in both eyes.
What is "Member Termed"?
Name the HEDIS call result that covers both members whose appointments are managed by a long-term care facility and members who are homebound with no available mobile providers.
What is "LTC/Homebound"?
This bird cannot fly but loves to swim.
What is a Penguin?