ask caller to hold while you update account-use one note- recap the call
Oops!
Check
Okay!
Check
15
WHAT SYSTEM CAN WE USE TO VERIFY WHY A RX IS REJECTING
DARWIN/PERFORM RX
Oops!
Check
Okay!
Check
banana
Go to last place!
Oops!
seesaw
Swap points!
Okay!
fairy
Take points!
5
10
15
20
25
baam
Lose 25 points!
Oops!
15
Member provides a PCP name that does not match what we have in CSI- HOW DO YOU HANDLE?
ask member where/location they see the pcp - provide member with BOTH PCP NAME AND LOCATION on file-offer to update the pcp
Oops!
Check
Okay!
Check
15
Member(minor) mother calling to get pcp INN-What questions do you ask?
caller full name/ph#/mbrs full name/dob/nonpublic item/address/ph#/pcp+pcp location
Oops!
Check
Okay!
Check
15
Mbr calls to check if their GHP account is active-agent adv acct active since 4.1.23- what should notes say?
MBR Called to confirm acct is active-verbally adv acct is active since 4.1.23
Oops!
Check
Okay!
Check
15
What are the basic principles of Documentation
who called. what did they need. how was the need resolved??
Oops!
Check
Okay!
Check
monster
Reset all scores!
Oops!
shark
Other team loses 25 points!
Okay!
rocket
Go to first place!
Okay!
thief
Give points!
5
10
15
20
25
15
name a statement that should be used on every call- and why
assurance statement- acknowledges the callers issue- lets them know you are happy to assist
Oops!
Check
Okay!
Check
seesaw
Swap points!
Oops!
gift
Win 10 points!
Okay!
fairy
Take points!
5
10
15
20
25
lifesaver
Give 5 points!
Oops!
15
When verifying a caller you find they have an individual named in the address field indicating they are in the care of another person. The member is under 18 . Can they make changes-like a pcp change
YES THE INDIVIDUAL CAN MAKE CHANGES LIKE A PCP CHANGE
Oops!
Check
Okay!
Check
15
what is the last question on the new member welcome script?
Do you have any other questions regarding the plan that I can assist you with today? Please remember our number is on the back of your ID card. You can also