Policy and Procedures
Laminated or framed photos, Laminated or framed certificates
What is allowed items/Secure floor policy
The caller passes disclosure and then brings the Bene on the line to give an authorization, I need to.
What is verify the bene first and last name.
Consumers state I didn't know I had this plan
What is fraud
Provide or confirm inaccurate information
What is Information accuracy
This must be completed no later than 10:00 AM the following day.
What is timesheet
To pass disclosure, the caller must provide 3 pieces of information.
What is the Marketplace
Doctors agree to accept the Medicare-approved amount as payment in full for covered Part B services and supplies.
What is accept assignment
I released PHI/PII incorrectly
What is Privacy and Disclaimers
Must notify my supervisor and call the IVR line to complete this.
What is the call out process
This is Required to pass disclosure in Medicare
What is Medicare number of Social Security Number or both
Medicare sends claim payment information to your supplemental insurance company after Medicare pays its portion of the claim.
What is Crossover
I did or did not close NGD calls records properly
What is business process
Canned Food, Sandwiches, sunflower seeds
what is not allowed/food policy
The caller is 18 and older and is on the application, and he/she wants to report a death to the Marketplace
What is Escalate too the Advanced Resolution Center
You can do this if you are in your initial enrollment period and you were automatically enrolled in Part B and your coverage is not effective yet.
What is declining part b coverage
Read all of the said language before selecting I agree statements for Consumers
What is attestation
The caller asks to speak with a supervisor
What is a warm transfer
This is the only valid authorization for a deceased Beneficiary
What is an executor authorization
Me or my supplemental insurance must pay my health care provider this before Medicare begins to pay for covered expenses.
What is a deductible
I listen and ask probing questions to understand the reason for the call and begin to pick up on the caller's cues.
What is active listening