Final Q#4

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  1. What is the name of the primary system that the call center uses to view member infomration and documents calls?
  2. Name 2 ways that a members records can be accessed
    • CIN#
    • Last Name, First name and DOB
  3. What is the standard greeting to open every call?
    Thank you for your patience this is Ismael, how may I help you?
  4. When verifying a membrs account (when the member/HOH is calling), what are the qualifiers?
    • Member's first and last name
    • DOB
    • address
    • phone#
  5. What screen requires additional verification if flagged "n"?
  6. What does "the string" consist of?
    Plan/Medical group/PCP/site ID
  7. Describe in words, as you would if on a call, the eligibility for the member below, for today's DOS.
    As of today's date the member is with LA Care, Health Care LA, Ipa medical group, with Dr Christina Huckabay.
  8. What info is needed/captured when a provider calls
    • Caller Name
    • Where calling from
    • caller phone#
  9. What is the LAC code when a meber calls to verify eligibility?
  10. What is the LAC code when a provider calls to verify eligibility?
  11. What template is used for eligibility calls?
  12. What info should be entered in the "Eligibility info given?" box
    "The string"
  13. When caller is requesting eligibility for a prior date of service, which screen should be used?
    Eligibility History
  14. If a member is a childk, who can call to make changeson their behalf?
    Parent/HOH and Authorized Representative
  15. When done for the day or leaving for lunch, what action should be taken in MEIS?
  16. Where can you locate call center technical procedures?
    MSCC tool
  17. What are the 3 required call text elements?
    • LAC code
    • call type
    • call status
  18. Once finished with a call, how do you prepare your screen for the next call?
    Clear member fields , clear cal dialog box
  19. Identify the site ID in the list below:
    A. 91362102C
    B. 1336154160
    C. A112856Z2
    D. A112856
    E. P0055695
    C. A112856Z2
    (this multiple choice question has been scrambled)
  20. What info goes in the "Elig given per" box?
Card Set:
Final Q#4
2013-10-22 22:34:34


final review
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