Slack Workflows
When will we use a request a manager slack workflow form?
Mental Crisis
Medical Emergency
Domestic Abuse
De-escalate member concern
A member is currently in the hospital and won`t be back home until after 3 months, what can we do?
Attempt a rebuttal offering online video options
Member has Home HRA,A1c POC, DEE, and Virtual HRA on their profile. The scripting prompts you to read the ECG screening, what should we do?
Skip that section as the member doesn`t have that screening on their profile.
What are the requirements to fill out a slack workflow for a gift card escalation?
4-6 weeks after visit
signify administrated
A member has strict schedule and can only have appointments on Monday`s and Fridays after 6pm. Our scheduling app currently doesn`t meet her preference. What can we do and what is the disposition we would use?
Disposition as Unscheduled- Member Cannot Attend Available Times leaving a note about member preferences
Member wants to schedule wife with him for the visit but the wife is grayed out in the possible household member section, stating 4/12 9-12pm. What does this mean?
The member wife has already had her visit completed on 4/12 9-12pm.
Member regularly gets their DEE exam through their doctor. Their profile keeps receiving NPIA`s because of the DEE exam, how can we remove this?
Fill out slack workflow Scheduling Escalation- Household NPIA DEE removal.
A BCBS member recently moved to a different state and wants to update their address. What is the procedure and disposition for a BCBS member when they move to a different state?
Verify DOB, update the address, and Disposition Unscheduled Member not on plan.
This does not apply to the following clients BCBS, HCSC, MMO, and Regence. Disposition as "Member not on plan".
An MEC just scheduled an appointment when a member tells you they no longer want the visit because they see their doctors frequently.
What should we attempt on the call? How to cancel the appointment? What is the disposition?
Attempt to rebuttal but if the member stills objects we will follow our decline closing. Cancel Appointment- Decline Service and disposition Member Decline- Frequnt Doctor Visits
A member is requesting a copy of their 2 Page Summary report, what are the methods to sending the form out to them?
Mail, FAX, and Email
We are attempting to reach out to Tony Hawk and Nick Cannon answers the line demanding we take Tony off the list then hangs up. We can`t confirm if he is authorized to schedule on the members behalf, what should we do?
Disposition No Answer
Member needs an ASL interpreter after scheduling the appointment, what is the name of the form we must fill out and what do we need to select under the Special Needs section?
Interpretation Request Google Form
Member requests sign language interpreter" icon in the Special Needs section
A member has their appointment today at 3-6pm and it is currently 8am as they realized we have the wrong address. The member moved 2 blocks down from their previous address. What can we do since the member wants their appointment.
We can keep the appointment since it is the same day and has not started we can fill out a Slack Workflow- Visit Escalation notifying SWAT to keep the appointment and update the address.
A member tells us he hasn`t received proper care from his health plan and talks about switching his insurance. We have attempted two rebuttals but he insist he can find a better plan, what is the right disposition?
Member Decline Unhappy with Plan
Member wants a Spanish provider for their In Home visit but they don`t have a family member who can translate for them. We check our scheduling calendar and we don`t have any Spanish providers. What can we do to make sure the member has Spanish services for the visit?
Add Akorbi to Provider Notes
Provider Notes for In-Home Visits:
Member request translation (Spanish). Please Call Translation Services 214-865-7716. Client ID:10489. Auth. Code: 87