Systems Check
A Tufts Health Together member is active in EVS but showing inactive in HRP. What kind of Docflo do you need to send?
Enrollment Docflo
A Tufts Health Together with UMass member must have a/an _____ PCP.
Umass
Is there anything else I can assist you with? Thank you for callinng Tufts Health Plan
False
What system do we use to view medical prior authorizations and appeals and grievances?
Medhok
True or false: When a Tufts Health Together member updates their information with Tufts Health Plan, you need to get their permission to contact MassHealth to share the updated contact information.
True
Thank you for calling Tufts Health Plan. My Name Is..... May I please have your member ID?
How long does a member registration pin last?
48 Hours
Evolent (RadMD)
What is the TAT for an ID Card for Together Members?
7-10 Business days
What needs to be verfied at the beginning of EVERY call?
HIPAA
1 Year
A Tufts Health Together member calls because their Doctor is saying the member is inactive. You check HRP. The member is inactive. What is the next system you check?
EVS
Referrals
True or False: Member's address is a REQUIRED Piece of HIPAA Verification?
False
True or False: Each member portal must have its own email address this includes all dependents regardless of age.
True
What System do you use to document ALL Calls?
CR
What is the name of the department that scores member services calls?
OQA
A member calls because they are having trouble logging into their Member Portal account. What do you do to help them?
Use the Member Access Management tool and Impersonate the member.