Member Outreach
Demographic Discrepancies (Compas, PCH, or disclosed by the applicant). The date of birth in Compas or on the application is incorrect. What should you do?
Continue the interview
Document the correct dob or demographic discrepancy in the contact history note.
Return the case to the original UW following current guidelines.
An applicant requesting to discuss the rate or to speak to a manager/ supervisor are sent to?
An Underwriting Specialist on the UW Inquiry Line.
The 3 Outbound disposition codes for Underwriting.
Answered Complete Interview.
Wrong Party Partial interview, call disconnected, no answer, left a message, or authorized party is unavailable.
Wrong Number The applicant cannot be reached at the telephone number.
A provider outreach case is considered successful when the following events occurs.
The fax number is received by google, the IVR, or speaking to a representative from the provider's office and the fax is successfully sent.
No response from the applicant
Complete an interview
Send an email to the original UW and the UW Leadership Team.
Incomplete Interview the item should be forwarded which work queue?
Letter Writing
Call Opening
Thank you for calling UnitedHealthcare Underwriting Department, this is (provide your first name only).
May I have your AARP Membership # or the telephone number you provided on your application to locate your account?”
“How may I help you today?”
The Outbound Disclaimer
I'd like you to know this call will be monitored and recorded for quality purposes.
If the application is in the Provider Outreach work queue and there is no provider information in the COMPAS contact history note and the UW Workbench Comments box?
Contact the Underwriter via email or Teams, for clarification of the provider contact information.
Request for a different effective date.
Advise the caller that you will inform the UW.
Document the request in the Contact History Note.
Inbound call the item is in the enrollment work queue.
Transfer the caller to Optum Customer Service.
Authenticate the Account
Note: NEVER ask for or obtain a social security number.
Unsuccessful Interviews
Document Compas
Dispose case in Breeze
No further action required.
How to add the provider outreach fax coversheet file from the ldrive to the UW workbench?
Number of days a withdrawn application can be reviewed.
120 days from the application signature and date.
This information is located in PCH.
Applicant and Provider Outreach Callback Line
844-808-3571
Agent calls on behalf of the applicant
“Thank you for calling on behalf of (applicant's name). The application is in Underwriting and we need to speak with the client. Since you are not an authorized representative, contact the Producer Helpdesk for information regarding your client's application at 888-381-8581.”
Note: DO NOT release specific outcome decisions about the application to the Agent.
Locate Account Information for Dialer Calls
WWE will provide the person's name and zip code.
Breeze will provide the membership number
Authenticate in Compas
Multiple Providers, how is the case handled when 1 provider outreach is unsuccessful?
No response to our request for office notes (medical records.)
Review PCH Global to determine if the requested information was received:
If received, advise the applicant we have the information from their provider. They should be hearing from United within the next 7 -14 business days.
If not received, advise the applicant we requested information from their provider. Once received, we will review their application.
Underwriting Mailing Address
UnitedHealthcare
Underwriting Department
PO Box 105331
Atlanta, GA 30348-5331
Free Form Question Error
When ending the call (outbound or inbound) state the following:
The Underwriting Department has follow-up [or further] questions for you to answer regarding your application. Unfortunately, the underwriting notes are incomplete, and clarification is required. We will attempt to call you again after the Underwriter clarifies their question(s). I apologize for the inconvenience; our team will reach back out to you to complete the interview shortly.
Request to Withdraw
If the Underwriter is no longer available, follow the steps below.
COMPAS
Email (Both Scenarios)
What should be done prior to making any follow up calls to providers?
Prior to conducting any follow-up calls, if we've successfully faxed the request for office notes, check PCH Global. Determine if the office notes have been received and watch for multiple providers.
Where to locate the reason for the withdrawal of the application.
Workbench