Transfer Protocols and Verification Procedures

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Based on the last instructions shared by Centene, when do you have to transfer to the ADVISOR TEAM? Options: All the scenarios related to cancellations, **Doesn’t need plan anymore**, **Doesn’t understand benefits/accessing benefits**, **Denied claims, authorizations, administrative issues**, **Received Medicaid, Medicare**, **Received other insurance from Employer or Spouse’s coverage**, **Moved to another state not covered by Ambetter**

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All the scenarios related to cancellations

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Based on the last updates shared, when do you have to transfer to Solutions? Options: Never, When the member asks me for a Supervisor, When in the Plan name says: Solutions - Off Exchange

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When in the Plan name says: Solutions - Off Exchange

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Based on the article: Caller Identity Verification --- What is the correct order to follow when it comes to verification?

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1- Full name 2- Member ID 3- DOB If member does not have the Member ID, then ask for: 1- Full name 2- DOB 3- Address and Phone # (This is taken as 1 verifier) If member does not have the Address and Phone #, then ask for: 1- Full name 2- DOB 3- Last 4 digits of Social Security #

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What does HIPPA stand for?

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HIPAA is a federal law that sets a national standard to protect medical records and other personal health information.