Member
True/False. A member can cancel a HCV without HIPAA verification.
True.
True/False. When scheduling a non-member for a HCV, they must confirm mailing address is the same as physical address?
False. Since non-member are not allowed to update the address, this question is not needed or mandated for non members.
True or False. SC's must status the HH member's account even if they are already statused as a refusal on a declined call?
False. If a HH member is already statused as a refusal, we do NOT need to re-status. SC's do still have to notate.
Yes/No. You are allowed to offer a virtual visit to a member who requests an interpreter?
No.
What is considered the source of truth for correct plan branding?
The Call Script.
True/False. SCs must identify/name all HH members/non members with member on a non-scheduled call.
False.
Yes. Any positive response from the non-member is acceptable to complete authorization.
When should the status "Not Interested" be used?
As last resort or when member does not provide a reason.
What must an SC do if the member requests for the call not to be recorded?
Use the provided talking points if possible. If member still requests for it not to be recorded, submit a complaint. Continue the call.
True/False. "This call is being monitored" in acceptable for the recording disclosure.
False. "May be recorded" or "monitored" are not acceptable.
True/False. You are not allowed to provide the name of the LHP scheduled for a HCV to a member without HIPAA.
False.
Are you allowed to confirm appointment details that are already listed on the call script with non-members?
Yes. Once HIPAA verification has been completed, SCs may disclose home details, landmarks, special instructions, PCP already noted in the call script.
What is the correct status for a member who has bed bugs?
"I don't a stranger in my home."
What are the two times we reach out to LHP for HCV cancellations?
Same day cancellations & next day cancellations if the member calls AFTER 6pm THEIR time
True. SCs verbiage may not change the meaning or requirements of TCPA.
True/False. If a member reschedules and updated their communication preferences, SCs do not have to read the disclosures?
False. If at any point, SMS or Email preferences are updated (new number, new email, etc.), SCs must re-read the disclosures.
What address must the non-member provide for complete and correct HIPAA verification?
Full Address
What is the correct status for a member who is moving?
"Talked to Member"
What is the correct status to be used with an abusive member?
"Safety Issue Unable to Schedule." Please be mindful of this status as it does trigger DNV consideration automatically.
True/False. A member's full name may not be collected before the recording disclosure is provided?
False. You may collect the full name of the member. But any additional PHI may NOT be collected until after the recording disclosure has been provided.
Yes/No. A member may use a wrong/invalid phone number as HIPAA verification.
Yes. If the phone number being used to speak with a member is already listed on the account(s), it can be used as one piece of HIPAA verification by stating it out loud. If scheduling coordinators are able to speak with the member on a Wrong/Invalid phone number, this number can be considered as a piece of HIPAA verification for the current call. However, scheduling coordinators must mark the phone number as Wrong/Invalid accordingly.
True/False. SCs must handle reluctance with a non authorized non member if they declined a HCV.
False.
Yes/No. SCs must still provide our TFN if the "skeptical of program validity" status is used?
No.
What is the difference between Do Not Call and Do Not Contact?
Do Not Call: Member no longer wants to receive Outbound calls from HouseCalls.
Do Not Contact: Member no longer wants to receive Outreach of any kind from HouseCalls including mailers. Typically, this will be noted in the DNC/DNV tab.
True/False. On an inbound call, we are allowed to disclose we are United Health Care if the member pushes as to what company we are with?
False. We are to introduce ourselves as Housecalls until we are able to successfully identify the member and their account.