Welcome to Medicare

Day 01

100

What is the goal of every call?

What is First-contact resolution?

200

Receive the call

Listen, question and confirm

Provide solutions

Transfer or close the call

What are the 4 phases of the Call Management Framework?

300

A group of CSRs that help other CSRs. They assist when the CSR is unsure of what to do or how to handle a call. 

Who is ISG (Internal Support Group)?

400

People 65 and older

People receiving disability benefits from SSA or RRB

People who have end-stage renal disease (ESRD)

Who does Medicare cover?

500

What are the 4 parts of Medicare and describe what they cover?

Part A- Hospital Insurance (inpatient services)

Part B- Medical Insurance (outpatient care, medical equipment, preventive services

Part D- Prescription Drug coverage

Part C- Medicare Advantage plan bundles Parts A and B including D offer extra benefits through private insurance.

Day 02

100

BCC Tier 1 screen

What is where most of your call begin in NGD?

200

List and Form

What are two types of applets in NGD?

300

Also known as the Welcome Mat

What is the Content Viewer?

400

Which two privacy laws govern how PHI and PII are handled?

What is The Privacy Act of 1974 and HIPAA?

500

What actions are required for beneficiary messages?

What is check message only if the Current Beneficiary Message indicator is present, must read message if it is unread and related to the reason for the call unless otherwise noted, don't have to read if it is not related, must pass disclosure before message can be read to beneficiary and must be authorized to read message to someone other than beneficiary?

Day 03

100

What script answers the caller's questions about eligibility and enrollment for Original Medicare?

What is Part A and Part B Eligibility and Enrollment script?

200

What are the 4 enrollment periods for Part A and Part B?

What is Initial Enrollment Period- 7 month window (3 months before, the month of and 3 months after 65 birthday), General Enrollment Period- Jan 1- March 31 each year coverage start 1 of following month after enrolling, Special Enrollment Period- Life change events, Transfer Enrollment Period- must be 65 or older & eligible for Part B, must be enrolled in MA plan or 1876 cost plan, begins 30 days after the end of the month they leave the plan or plan coverage ends?

300

What script can answer questions about the Medicare number or card?

What is General Questions about your Medicare number and card script or Your Medicare Number and Card Script?

400

What view on the BCC Tier 1 screen provides a summary of the beneficiary's enrollment information?

What is New to Medicare view?

500

What is the name of the Medicare publication that CMS provides all beneficiaries every year?

What is the Medicare & You Handbook?

Day 04

100

How many days can a temporary or verbal authorization be made effective for?

What is just for that conversation or up to 14 calendar days?

200

What button in NGD do you click to start the process of adding an authorization on the beneficiary's record?

What is Add Authorization button to launch the Authoriaztion task?

300

If a caller has a Medicare Summary Notice (MSN) and passes disclosure, what information can you share with the caller?

What is if the caller can pass disclosure but does not have an authorization on file, you may only answer questions and discuss the claims that appear on the MSN that the caller has with them?

400

Which script will you use to help with questions or issues regarding incorrect demographic information on file?

What is Changes to Personal information script?

500

Which system gets updated after the BIC (Beneficiary in the Cloud) system?

What is CWF (Common Working File)?

Script It!

100

How long must the beneficiary be out of an inpatient facility for the Part A deductible to reset?

What is after 60 consecutive days out of an inpatient hospital, the beneficiary is required to pay the deductible again if they are admitted to an inpatient facility?

200

What is a limiting charge?

What is if a doctor or other health care provider is nonparticipating, he or she can choose to charge a beneficiary up to 15% about the Medicare-approved amount. The limiting charge only applies to certain services. 

300

Free Money!!!

Ain't no Question Here

400

What is the timeframe for Medicare to pay a finalized claim?

What is claims filed electronically- 14 days after received, paper filed- 29 days after received?

500

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