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Sally is navigating the IVR and it continuously leads to the IVR hanging up or she is stuck in a loop. What process task option should she select?
What is .....IVR Navigation Failure
Agent puts Eva on a EXTENDED hold and is unresponsive to "Are you still there" or "Can we please proceed". After disconnecting what input reason will you select?
What is.......Unexplained Outbound Hangup
John from united healthcare answers and verifies HIPPA but states he is unable to locate the member. After confirming he is unable to look up account by member ID and name/DOB what process task reason would you select?
What is....Agent unable to locate member.
Henry from Aetna disconnected IMMEDIATELY as EVA started speaking. What input reason will you select?
What is.......Agent refused to speak to AI voice
William is on a call with Cigna and they are unable to continue the call because we do not have a provider OR practice tax id. What process task reason will you select?
What is..... Missing Input information
Cassandra called Humana and they stated this years benefits have not been loaded yet. Please call back in 14days to retrieve the correct benefits.There is no other active plan. What incomplete reason would you select?
What is......Current year's benefits are not yet loaded
Tiffany from Cigna inq if Eva was calling from a third party and when eva adv she was the agent wasn't able to continue the call. What incomplete process task reason will you use?
What is .......Agent refused to give benefit info to 3rd party
Shana from BCBS asked for the member DOB and she adv the member DOB you provided is incorrect and she is unable to proceed with the wrong date of birth what incomplete task reason will you select?
What is...... Incorrect Input information??
Alana from Aetna kept giving contradicting answers to eva or kept saying "I dont know", "Im not sure" etc. What incomplete reason will you select?
What is........Agent Provided Unreliable Data
If you have to disconnect for any reason other than what is on the "Process Task Feature" document then what will you select for incomplete reason?
What is........Other - Specify in Notes
If you are on a call and recording is terminated by nexmo. What incomplete reason will you use??
What is.......Operator Portal Failure
Todays date is 3/10/2022. Sarah from BCBS IL states they found patients account and it has a effective date of 4/01/2022. They show no other active account on file. What process task reason will you choose?
What is ...... Agent unable to locate active member plan
While on a call you realized you missed a few questions. What incomplete reason will you select?
What is .......Operator Error, Specifics can be logged
Dustin from Humana states that they have located the patient in the system, but they do not have access to the plan or information on how to reach the correct department. What process task reason will you use?
What is .....Agent unable to locate active member plan.
Call is routed to Emily at BEST BUY. After disconnecting what incomplete reason will you use?
What is...........Other - specify in Notes
(Call is to a non-supported payer)
Allison from United Healthcare is having audio issues and you have to disconnect. What incomplete reason will you select?
What is......Payer System Issue
Humana provider line is open from 8:00am-5:30pm Mon - Fri. When you get dropped in a call it's 5:35 and the recording says they are now closed. What incomplete reason will you select?
What is.....Payer Not Reachable
If the call has disconnected and it requires a PIE escalation what incomplete reason would you select if you are not calling right back?
What is......PIE Escalation Needed
Agent transfer call to another department but its incomplete or there is a issue with the transfer what incomplete reason will you select?
What is....Agent transferred the call to incorrect department
You call on a Cigna Medicare Advantage(800-668-3813) account (U5846795846) and they are unable to locate account. What incomplete reason will you select?
What is .......Need to call different phone number??
In this example the id starts with a "U" and according to "Identifying Insurances" "U" IDs are Cigna Commercial and we must call : 800-244-6224.
For certain payers where if the agent is unable to locate an active member plan, SOP is to make another call to a different number first (e.g., general blue card line for BC plans) before failing.
In California, you can’t legally buy a mousetrap without having what?
What is......A hunting license
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