Quoting Medical Benefit

What intent should you used when Quoting Medical Benefits?

• Send Informative Email

• Review Medical Claims History

• Review Medical Benefits

• Medicaid Coverage

What job aid should be use when handling Dental Concerns?

• Benefit inquiries

• Quoting Benefits Decision Tree

• HIPAA

• Dental Coverage

What job aid are we going to use when handling Vision concerns?

• Dental Coverage

• Vision Coverage

• Benefit inquiries

• HIPAA

Sometime you may not initally understand the reason the member is calling and therefore its important to ask clarifying questions. What it is that you need in order to determine the exact reason of the call?

• Open Ended Question

• Closed Ended Question

• Probing Questions

• Sample questions

What do we call the tool we used in determining copayments or coinsurance and additional information of the benefits of the member?

• Rally

• iBAAG

• UES

• Qualtrics

Use the MID: 900990425 for the following numbers.

Is the member covered for any Out of network Benefits?

• YES

• NO

Member is calling verifying how much is her copayment for her Primary Care Visit. What is the correct copayment of the member?

• $50.00

• $5.00

• $0.00

• $3.00

What is the meaning of iBAAG?

• Internet Benefits at a Gap

• Intranet Benefits at a Glance

• Internet Benefits at a Gross

• Intranet Benefits at a Glips

Does the member needs a referral to see a Specialist?

• YES

• NO

What's the Contract Segment PBP number of the plan?

• H5253-062-000

• H5253-063-000

• H3553-062-000

• H5223-062-000