A member calls Customer Service to ask benefit questions. During the conversation, the member mentions they haven't had an appetite lately because they are depressed. How would you handle the call?

A member calls Customer Service upset about WellCare denying her doctor’s authorization request for bariatric surgery. She wants us to reconsider our decision. What would this be considered?

A member calls with questions about hearing aid benefits. Which CAREConnects call driver would you select to assist the member?

An Iowa member can call the 24 hour nurse advice line for help related to which of the following:

As a Customer Service Representative (CSR), you are required to complete verification before providing any account specific information.

As a Customer Service Representative, you are required to check the system to determine if the caller has legal authorization to act on behalf of a Member.

Bob is calling to change his PCP. He does not qualify for an exception but he still wants his PCP changed. Today is the 12th of August. What day will the PCP change take effect?

Frank is calling to change his wife’s PCP for her. In order to change the PCP, what must Frank be listed as on his wife’s account?

Iowa Medicaid State Eligibility portal is an online application WellCare uses to view Iowa Medicaid eligibility for Members and Providers.

Members are able to file a grievance by mail, fax or phone.

Mr. Edwards just received his ID card. He is not happy with the PCP listed on his ID card. What is the primary call driver you will choose in CAREConnects?

Mr. Porter is calling to order a new ID card for his wife Jenna. Which Caller Type should be selected in CAREConnects?

Ms. Clark calls WellCare Customer Service. She is expecting her first child and was recently laid off from her job. She previously had medical insurance through her employer. What will you tell her?

Ms. Taylor calls WellCare. She has recently enrolled in the Iowa Medicaid plan and has not received her ID card yet. What call driver would you select in CAREConnects?

The CMS Appointment of Representative (AOR) form is also known as what?

What call driver should be used when submitting a request to have a Portuguese translator present for a member’s doctor appointment?

What do you do when a member’s account shows as having other insurance (coordination of benefits) but they indicate that is not valid?

What is the timeframe for WellCare to respond to an expedited appeal request from an Iowa member?

Which of the following information is NOT included on the Member's ID card?

Which of the following is a standard Customer service call opening?

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