BASICS
The only Bot we can talk to
"Who is Eva?"
Member ID, Member Name, Member DOB
"What is info we need to correctly HIPPA verify a member?"
Something I should have pulled up at the start of every day to get to job aids/SOPS for multiple LOB
"What is APRIL Tool?"
Common provider Identification Numbers
"What is Tax ID or NPI?"
EOB is an acronym for.
"What is Explanation of Benefits?"
UHC Mission
"What is - to help people live healthier lives and make the health system better for everyone?"
"Thank you for calling. My name is___, your Provider Service Advocate. May I have your name please" (Or something to that nature.)
"What is a call opening?"
2 Primary Call Handling Resources
"What is UHC Provider Service Advocate Toolkit and Advocate Call Handling One Source"
This provider completes initial assessment of a member?
"What is a PCP?"
PRA is an acronym for
"What is Provider Remittance Advice?"
PHI is an acronym for
"What is Protected Health Information?"
Is there anything else I can help you with today. Offer reference number. Prompt for survey.
"What is a call closing?"
The name of the system we use to pull our member accounts when taking calls/chats.
"What is SPIRE?"
Providers who are not guaranteed payments from UHC?
"What is non Par/OON providers?"
The length of time I am able to hold for, once stated.
"What is two minutes?"
A set of behaviors applied to ensure you get all the information you need to identify and resolve a caller's issue or question.
"What is Active Listening?"
This law guarantees patients’ rights and protection against misuse or disclosure of their health records.
"What is HIPPA?"
Source of truth for HIPPA
"What is the HIPPA Confidentiality Reference Tool?"
Reimbursement type refers to a set amount of money paid to the provider usually monthly?
"What is Capitation?"
2 systems used to fax documents to providers
"What is Outlook and RightFax?"
United HealthCare Core Values
"What is Integrity, Compassion, Inclusion, Relationships, Innovation, and Performance?"
Something that we have to promote on each call
"What is Digital First?"
System used to house all SOP's among all Lines of business.
"What is Knowledge Central?"
Fee for service, capitation, contract, special arrangement, and withhold are examples of.
"What is reimbursement types?"
Used when additional research is required on a call
"What is hold?"