Sunflower Appreciation Jeopardy

Centralpoint Article

100

It used to be called Service Transformation.

What is the Member Call Flow Procedure?

200

Safe Ride did not show up to pick up a member.

What is the Missed Transportation Process?

300

The best place to find a phone number.

What is the Contacts and Resource Guide?

400

Member has been sent to collections.

What is Balance Billing (Member Received a Bill)?

500

Member states intention to harm self.

What is Handling Challenging and Crisis Calls?

OMNI Intent Name

100

Parent wants to update pediatrician for child.

What is Update PCP?

200

Member has BCBS as primary insurance.

What is Coordination of Benefits?

300

Member wants something done about a denied authorization.

What is the Issues?

400

The enrollment span is requested.

What is Benefits and Eligibility?

500

Member wants to show they are Native American.

What is Update Member Preferences?

Acronym Stands For

100

CSA is the face of the company.

What is Customer Service Advocate?

200

FCR is a critical component for any company.

What is First Call Resolution?

300

CIV must be captured before sharing any protected health information.

What is Caller Identity Verification?

400

HIPAA is in place to protect our members and providers?

What is Health Insurance and Portability Act?

500

CAHPS looks at Member Experience through quality and performance improvement.

What is Consumer Assessment of Healthcare Providers and Systems?

Name That System

100

All calls must be documented.

What is OMNI?

200

Provider is checking on network status.

What is Portico?

300

A copy of the denied authorization letter is requested.

What is Trucare?

400

Member needs rewards balance.

What is My Care Card?

500

Back up system when OMNI goes down.

What is Dauntless?

Templates

100

Member Name:
Member ID Number:
Member Language:
Date/Time/Expected Duration of Appointment:
Nature of Appointment (physical, med check, therapy, etc.):
Doctor/Provider's Name:
Name/Address/Telephone of Clinic/Facility/Hospital where appointment will take place:
Name and telephone of the person requesting interpretation services:
Provider must document that interpretation services were provided including interpreter ID, language, appointment date and services provided as well as their number or agency.

What is the face to face interpreter?

200

Enter the following information in the comment box based on your market's requirements:

• Member's Amisys (U) Number
• Date of Birth
• Gender
• State what applicable reward is being disputed 
• Date of Service and/or Reward Completion Date
• Provider's Name
• Provider's Contact information
• Reason for Escalation

What is the member rewards?

300

Member ID:
Callers Name/Relationship:
Issue:
CB #:
Name of SafeRide Agent if applicable:
Was grievance filed Y/N:
Grievance OMNI ID or NA:

What is the Safe Ride?

400

call to complete survey
Member Name  
Member ID    
contact phone 

caller name and relationship if not member 

any additional notes such as specific times available or language needs 

What is the HRS or Health Risk Survey?

500

Caller's Name:
Callback Number:
Member's Name:
Member ID Number:
OMNI Reference Number:
Issue:

What is the Member Escalated or Supervisor?