WorksheetsC3 New Hire-CARE, HIPAA, Call Mgmt, ID Cards & Eligibility
Total questions: 14
Worksheet time: 11mins
The 3 primary HIPPA Identifiers are:
Member's full name, address on file & SSN
Member's full name, phone # on file & DOB
Phone # on file, DOB & Address on file
Member's ID, Member's full name and Member's DOB
Associates in possession of ______________ are accountable to protect that information at all times, including while at work, at home, and while traveling.
Anthem Purpose, Vision and Values
Protected Health Information (PHI)
Heath Insurance Portability and Accountability Act (HIPAA)
Company Websites
A caller tells you they are calling for their sister and proceeds to give you their information. You notice that the caller is NOT listed on the policy. What is your next step?
No further action is needed
Request the caller provide the MEMBER’S full name and date of birth before you can disclose any PHI
Ask if the member is available to speak with
Request that the member be present on the call for you to disclose information
Susie, a member on the plan calls requesting her information. What would you choose for who is contacting us on the HIPAA Tool?
Member
Subscriber
Informal Representative
BCBS Plans or other insurance plans
Every time an associate steps away from his/her computer, he/she must lock the computer.
Press F12 + Esc and select Lock OR press Alt + Tab and the letter E key
Press Control + Alt + Delete and select Lock Computer OR hold the Windows key + the letter L key
Press Control + Alt + End and select Log Off OR press the Shift key + the letter X key
What should I do differently if the member’s Relationship Status is listed as Unknown in Solution Central?
Select the gender pronoun based on the member’s name
Ask the member what is their gender
Do not use any pronouns when speaking with the member
Contact your manager or OE to report an issue with Solution Central
If a caller does NOT have his/her member ID number and will NOT give the Social Security Number, which other piece of identification can you obtain instead as an alternate verifier?
Caller's mother's maiden name
Caller's address
Name of the caller's employer
Name of the caller's medical plan
Which system houses the Confidential Communication and HIPAA Authorizations?
Clarity
Mainframe
Solution Central
CIRS
Which of the following DOES NOT define “no healthcare homework”?
Follow-up timely when issues have been corrected
Tell the member they need to contact the provider to get the information
Call providers and vendors to get information for our members
What are a few things we can do to ensure we “Connect with the customer on a personal level and show genuine interest”?
Use the customer’s name to build rapport, have patience and allow the caller to speak and provide assurance by acknowledging their concerns
Stick only with the questions at hand, and do not attempt to make a connection with the caller
Stick only with the questions at hand, and do not attempt to make a connection with the caller
Put the member on hold immediately after the call comes in
How can we “Always communicate with confidence and knowledge”?
Tell the member what they need to do
Ask probing questions to determine member’s needs, respond with simple insurance terms to ensure understanding, frame negative information in a positive way and use proper grammar
Ask yes or no questions and tell them you will call them back
Tell the member that you think you can locate the answer for them
How long is a member eligible for Federal COBRA coverage when the employee, as well as their spouse and their dependents, lose coverage because of a termination or reduction of hours?
12 months
18 months
24 months
36 months
You have an angry, upset member on the phone. They’ve called in six times to request an ID card. What should you allow the member to do to communicate their reason for
calling?
Interrupt the member with questions
Allow the member to vent and express their feelings
Ask them to repeat information they’ve already provided
When ordering an ID card in Solution Central, what standard fulfillment method options are available?
Mail, digital, electronic (email)
Member must use Sydney to obtain their ID card
Clarity
