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Dr. Hemingway calls and you cannot locate him using basic and advanced searches in CAREConnects. What action would you take next?
Select the Non-Par Provider button and enter the provider's information manually.
All callers
Health Services Authorizations
Material Request
Establish a positive first impression.
Credentialing
Which insurer has primary responsibility.
Caller is Dissatisfied/Upset
If you are unable to determine if a CPT code needs an authorization using the Auth Look Up Tool, where should you transfer the call?
Select the Non-Par Provider button and enter the provider's information manually.
All callers
Health Services Authorizations
Material Request
Establish a positive first impression.
Credentialing
Which insurer has primary responsibility.
Caller is Dissatisfied/Upset
If the member has more than one insurer, what must the provider identify prior submitting a claim to WellCare?
Select the Non-Par Provider button and enter the provider's information manually.
All callers
Health Services Authorizations
Material Request
Establish a positive first impression.
Credentialing
Which insurer has primary responsibility.
Caller is Dissatisfied/Upset
John is calling to request a new ID card. He states that he is new to the plan and has not received an ID card yet. What call driver would you select to assist this Member in CAREconnects?
Select the Non-Par Provider button and enter the provider's information manually.
All callers
Health Services Authorizations
Material Request
Establish a positive first impression.
Credentialing
Which insurer has primary responsibility.
Caller is Dissatisfied/Upset
What is the name of the process used to evaluate the qualifications and credentials of providers?
Select the Non-Par Provider button and enter the provider's information manually.
All callers
Health Services Authorizations
Material Request
Establish a positive first impression.
Credentialing
Which insurer has primary responsibility.
Caller is Dissatisfied/Upset
Which of the following is not a way to show empathy to a customer?
Select the Non-Par Provider button and enter the provider's information manually.
All callers
Health Services Authorizations
Material Request
Establish a positive first impression.
Credentialing
Which insurer has primary responsibility.
Caller is Dissatisfied/Upset
At the end of a call, the member is upset or dissatisfied. What button in CAREConnects would you use to escalate the call?
Select the Non-Par Provider button and enter the provider's information manually.
All callers
Health Services Authorizations
Material Request
Establish a positive first impression.
Credentialing
Which insurer has primary responsibility.
Caller is Dissatisfied/Upset
A Customer Service Representative must log calls received from ____________?
Select the Non-Par Provider button and enter the provider's information manually.
All callers
Health Services Authorizations
Material Request
Establish a positive first impression.
Credentialing
Which insurer has primary responsibility.
Caller is Dissatisfied/Upset
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