Resources
This is the system where all our member's profiles are housed.
What is "MEP"?
This is provided from the health plan with all the members info and benefits.
What is the "Eligibility file"?
This is the preferred way to searching for OTC items.
What is "Item number"?
This two step process will bring up information on all past OTC orders placed.
What is "Nations Tab > Click Order History"?
This is where you can find the beginning script of your call flow.
What is the "Genesys"?
This system is the Employee Encyclopedia for all of NationsBenefits information.
What is "TheNow"
This plan allows a member with a grocery benefit to purchase anything that is edible.
What is "Elevance Anthem"?
Clicking the My Benefits tab on the storefront homepage is where you would go to find out more information on this?
What is "Wallet or Wallet types"?
This is the name of the companies we use for shipping OTC orders.
What is "UPS and Fedex"?
This information must be provided to the member before starting a new OTC order.
What is "OTC Balance"?
This is the URL for employees and members to access the OTC Storefront.
What is "HealthPlan.nationsbenefits.com"?
This Health Plan's beginning script starts with, "Thank you for calling members services.."
What is "Elevance"?
Best search practice: Member does not have an item number and requests Tylenol PM, this would be the best way to search by name.
What is "Search the first few letters of the item (Tyl) to avoid spelling errors and missed items"?
These two places allows you to place an order for an OTC catalog.
What is "Nations Store Tab or Storefront under Account > Nations Store"?
This is the shipping times for all OTC orders including reshipments.
What is "(2) two days"?
After thoroughly searching TheNow for answers, this resource can be used to contact a supervisor or Subject Matter Expert
What is "Teams"?
These are the 13 health plans that allow reimbursements.
What is "Elevance, Aetna, BCBS RI, CCOK, CDPHP, Capital Health Plan, Clear Spring, eternalHealth, Florida Blue, FirstMedicare Direct, Geisinger, Health Alliance Medical Plan, and SelectHealth."
Scenario: Member has $3 in their OTC wallet (Blue Dot) and $0 in their grocery wallet (Red Dot). Member would like a grocery item (Red Dot) for $3. In order to purchase the item, the member will need to?
What is "Pay for the item out of pocket"?
This will be the call disposition for an OTC call where a 3rd party representative placed an order.
What is "OTC - Member Representative - Order Placed"?
This must be provided before clicking "Confirm Order".
What is "Product Disclaimer"?
This resource has the ability to allow you to see who is calling/how to brand your call.
What is the "Genesys"?
This health plan requires us to check if the member has an AOR on file or get a verbal consent from the member for every service request requested by a 3rd party.
What is "CCOK-Community Care of Oklahoma"?
Member has $2 remaining in OTC balance and is done picking items. This will prompt you to do this.
What is "Recommend using remaining balance and offer to conduct search for $2 items available"
This is where you should first notate before closing out MEP and accepting a new call.
What is "Genesys"?
This page in The Now is used for call note templates.
What is "MEA Note Templates"?