GNMS: Wk3_Day1_AM Review

When you need to go back to a past case and review it for a follow up, where would you locate the case?

• Communication Preferences

• My Dashboard

• Child Case

• Member Holistic Dashboard

What can you do to help de-escalate an angry caller? Choose all that apply.

• Stay calm

• Interrupt the caller before they get more heated

• Be endearing by using words like hon and dear

• Be mindful of your tone

The Customer Advocate Call Flow is the . . .

• integration of ServiceMentor and using ACE to resolve inquiries

• connect and closing portion of the call

• way the call moves through the CTI Softphone system

• integration of ACE and ProcedureFlow to help answer inquiries

What is the most likely reason why a member has multiple group numbers?

• HCSC made an error and set up multiple accounts

• The member has had multiple policies with HCSC throughout the years

• The member has had multiple children added to the same policy

• To track member information for marketing different products

What should you do if a customer asks any of the following questions?

Will my 26-year-old son automatically be removed from my policy?

Will my newborn receive benefits?

Are my kids listed on my plan?

• Look up provider information for the member

• Get ready to use the After Call Work feature on the CTI Softphone

• Think about the steps you will take to determine who is on the member’s policy

• Think about the steps you will take to gain verbal authorization

What are some examples of qualifying events for COBRA coverage? Choose all that apply.

• A child turns 26

• A member has switched to another BCBS plan

• A member goes through a divorce

• The subscriber loses their job