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What is the name of the primary system that the call center uses to view member infomration and documents calls?
MEIS
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Name 2 ways that a members records can be accessed
- CIN#
- Last Name, First name and DOB
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What is the standard greeting to open every call?
Thank you for your patience this is Ismael, how may I help you?
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When verifying a membrs account (when the member/HOH is calling), what are the qualifiers?
- Member's first and last name
- DOB
- address
- phone#
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What screen requires additional verification if flagged "n"?
C&L
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What does "the string" consist of?
Plan/Medical group/PCP/site ID
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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.
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What info is needed/captured when a provider calls
- Caller Name
- Where calling from
- caller phone#
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What is the LAC code when a meber calls to verify eligibility?
LAC#107
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What is the LAC code when a provider calls to verify eligibility?
LAC#149
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What template is used for eligibility calls?
F9
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What info should be entered in the "Eligibility info given?" box
"The string"
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When caller is requesting eligibility for a prior date of service, which screen should be used?
Eligibility History
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If a member is a childk, who can call to make changeson their behalf?
Parent/HOH and Authorized Representative
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When done for the day or leaving for lunch, what action should be taken in MEIS?
Logoff
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Where can you locate call center technical procedures?
MSCC tool
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What are the 3 required call text elements?
- LAC code
- call type
- call status
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Once finished with a call, how do you prepare your screen for the next call?
Clear member fields , clear cal dialog box
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Identify the site ID in the list below:
E. A112856Z2
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What info goes in the "Elig given per" box?
MEIS
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