Radiology
If someone tells you that they need an MRI of the joint with contrast, what should your next question be?
Where in Salesforce can you see if a member is eligible?
The eligibility page
Before anything else, what must come first?
Authentication
What are the three components of authentication
Name, DOB, Zip Code or Member ID
What department will assist you with doctor's orders?
Operations Support
These MRI scans should be done in a closed machine. (there are five, name at least three)
Brain, Breast, Joint, Arthrogram, Diagnosis of MS
Salesforce guides you towards specific client rules, what are two of those rules?
MVA, WC decisions
Authorization Requirements
Non-AI Scheduling
Other scheduling restrictions
When do you offer the survey?
Inbound member calls
What is the difference between authenticating a family member who is on the policy and one who isnt?
If they are not on the policy we must get verbal permission or confirm consent on file.
What client will we start working with first?
Central States Funds/Team Care
If someone tells you they need an MRA, what does that mean?
MRI Angiogram
How are you expected to search for the member first?
Name or Name and Date of Birth
When do you need to tell someone the call is being recorded?
At the beginning of an Outbound call
How do you authenticate when calling out to a doctor's office?
By giving them the name and DOB of the person you're calling about
When getting calls that were handled by another agent, what should you do?
You should assist the caller regardless of who's worked with them before.
How are the codes for MRI extremities categorized?
Joint, Non-Joint, Upper, Lower
Where in Salesforce do you find facilities?
Home Nearby Sites - Case
How should you close your call?
"Thank you for using/calling/speaking with US Imaging Network."
Call them back and authenticate them again
What department helps agents by answering questions through a Help Line?
OEs
How are the codes for CT extremities categorized?
Upper and Lower
If you confirm a MDO address and it does not match what do you do?
You should keep the correct address on a note until you can update it in the proper page, it does not get updated in the MDO account page
If you dont give someone an expected hold time, how long can you have them hold before checking in?
2 minutes
When can we take the Member ID as an alternate authentication component?
Only if the zip code does not match
Why are we calling?
To tell them about their benefits