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Complete Quick Reference Guide 3 Flipbook PDF
Complete Quick Reference Guide 3
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Nesting Quick Reference Guide
ModivCare Company Values
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Nesting Core Pillars
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Table of Content
Page Number
ModivCare Phone Numbers
5
Member Experience Calls
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Call Center Extensions / Interpreter Access Card
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How To: U Drive
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How To: Transfer/Conference Calls
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Military Time Conversion Chart
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Phonetic Alphabet
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SC Medicaid Service Area: North Carolina
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SC Medicaid Service Area: Georgia
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Note Type Defined / Service Animals
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Urgent Trip Verification
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Cancellation Same/Nest Day
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Trips Denied
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COVID-19
18,19
Dual Eligible Stretcher Trips
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Linking Trips / Complaints
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Lyft Trips
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Facility Not in Rolodex
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Eye Reservation
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Dental Reservation
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Unable to Reach TP
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Unable To Hear Member
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Rider No Show Policy
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RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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ModivCare Phone Numbers – Greenville SC Callout (Pesonal Use) 800-788-4082 Inclement Weather line 800-284-5150 Corporate Office 800-486-7647 Administrative Desk 866-910-7684 Administrative Fax 866-913-5804 Quality Assurance Fax 866-913-5806 Reservation Region 1 866-910-7688 Reservation Region 2 866-445-6860 Reservation Region 3 866-445-9954 Where’s My Ride Region 1 866-910-7889 Where’s My Ride Region 2 866-445-9962 Where’s My Ride Region 3 866-445-9964 TTY Assistance 866-288-3133 Facility Assistance 866-420-6231 (standing order/discharge) Facility Fax Region 1 866-420-6253 Facility Fax Region 2 877-272-3939 Facility Fax Region 3 877-272-3990 Nursing Home Fax - All 877-272-3486 Providers Assistance 866-910-7690 Provider Fax 866-910-7691 Compliance Fax Region 1 877-316-3446 Compliance Fax Region 2 877-272-3635 Compliance Fax Region 3 877-272-3657 Utilization Review Dept Fax 877-601-0530 (Exceptions Fax-Escort Letter)
General Mgr./Ops Dir. Fax Manager Fax Fraud and Abuse Hotline Gas Reimbursement Medicaid Insurance Medicare Reservations Medicare Where’s My Ride Humana Reservations Humana Where’s My Ride United Reservations United Where’s My Ride Member Information Site Facility Information Site Mobile App Support
866-913-5805 866-886-4327 888-364-3224 800-930-9060 888-549-0820 855-693-2897 855-693-2898 866-588-5122 866-588-5123 866-418-9812 866-418-9813 https://memberinfo.logisticare.com/ https://facilityinfo.logisticare.com/scfacility 866-402-5752
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Member Experience Calls If a member calls in regarding a complaint or restriction on the account, please use the member’s last name to direct them to the correct person: Based on Member Last Name
Region 1
Region 2
Region 3 All Regions
A-M
N-Z
Shaneise Grady 2385
Molly Philemon 2313
A-I
J-R
S-Z
Sandra White 2386
Maria Pimentellluberes 2327
Tearrenee Morris 2333
A-I
J-R
S-Z
Sonya Anderson 2329
Mary Master 2330
Deon Wakefield 2334
Accidents & Incidents Hugh Rodgers 2332
Karen Hawkins 2203
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Call Center Extensions To reach Supervisors, Leads, Support Coach or Front Desk who are NOT logged onto Five9, please use the following: Billy Bobby Sheanette Terry Latonya Nadie Kenzie Kathy
555-432-2370 555-432-2404 555-432-2210 555-432-2407 555-432-2352 555-432-2414 555-432-2208 555-432-2200
To reach an agent that IS logged onto Five9: Type in their name Dial
ModivCare – Interpreter Access Card 1. 2. 3. 4.
Dial: 211 or 866-745-5010 Enter Pin/Contract Number: 179 Enter Your Five9 Agent ID: XXXXXXX Customer Service – 0 Spanish – 1 Russian – 2 Mandarin – 3 Cantonese – 4 Arabic – 5 Working Effectively with Interpreters
Allow the Interpreter to greet you and the caller Speak directly to your caller in the first person Use short but complete phrases Be patience, the Interpreter may need to ask for repetitions Allow Interpreter to clarify linguistic and cultural issues
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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How To: U Drive
Open File Explorer
Open This PC
Select GDC02 – One Logisticare Share (U: )
Select Coaching and Support Team Folder
Select Nesting Folder Reference Guide Folder
South Carolina
Quick
Under the “Quick Reference Guide” Folder, you will find all our quick references individually or all in a single document. You will also have the link to the online “Quick Reference Booklet.”
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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How To: Transfer/Conference Calls Transfer A Call: 1. Change call state to “Call Park” (3 Bars In Top Left-hand Corner) 2. Put the Member on “Hold” 3. Click “Transfer” 4. Click “Other” 5. Click “Warm” 6. Enter Leads Extension (Or Person You Are Trying To Reach) 7. Click “Complete Transfer” 8. Click “Transferred to 3rd Party” 9. Click “Initiate Transfer” 10. Click “Complete Transfer”
Conference A Call: 1. Change call state to “Call Park” (3 Bars In Top Left-hand Corner) 2. Click “Park” 3. Click “New Call” 4. Dial 5. Once ready, Click “Conference” on top blue bar
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Military Time Conversion Chart Regular Time
Military Time
Midnight
0000
1:00 am
0100
2:00 am
0200
3:00 am
0300
4:00 am
0400
5:00 am
0500
6:00 am
0600
7:00 am
0700
8:00 am
0800
9:00 am
0900
10:00 am
1000
11:00 am
1100
Noon
1200
1:00 pm
1300
2:00 pm
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3:00 pm
1500
4:00 pm
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5:00 pm
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6:00 pm
1800
7:00 pm
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8:00 pm
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9:00 pm
2100
10:00 pm
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11:00 pm
2300
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Phonetic Alphabet A B C D E F G H I J K L M
Alpha Bravo Charile Delta Echo Foxtrot Golf Hotel India Juliet Kilo Lima Mike
N O P Q R S T U V W X Y Z
November Oscar Papa Quebec Romeo Sierra Tango Uniform Victor Whiskey X-Ray Yankee Zulu
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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South Carolina Medicaid Service Area: North Carolina Abbotsburg Abewrdeen Addor Aleander Mills Aliexis Allen Allenton Alma Ansonville Anitioch Arden Ash Avery Creek Bager City Balsom Grove Barnesville Bat Cave Bellamy Belmont Belwood Bessemer City Bethel Bladenboro Boardman Boger City Boiling Springs Bostic Brevard Brief Broadman Brunswick Bughill Buie Bulters Calabash Callasaja Casar Cashiers Cedar Hill
Cedar Mnt Cerro Gordo Chadbourn Charoltte Cherry Grove Cherryville Chimney Rock Clarendon Cliffside Cognac Columbus Cordova Carmerton Crouse Crowders Cruso Cullowhee Dallas Double Shoals Dulah E. Flatrock Earl East Laport East Grove Edneyville Ellenboro Ellerbe Etowah Evergreen Fair Bluff Fairmont Fairview Fallston Flat Rock Fletcher Forest City Fountain Hill Franklin
Fruitland Gastonia Ghio Gibson Gilkey Glenville Gneiss Goodsonville Grissettown Grover Hallsboro Hamlet Harrisburg Hasty Hendersonville Henrietta High Shoals High Hampton Highlands Hoffman Holden Beach Hollis Hoods Horse Shoe Huntersville Indian Trail Iron Hill Iron Station Johns Kings Mountain Lake Waccamaw Lake Toxaway Lake Lure Lattimore Laurel Hill Laurinburg Lawndale Lilesville
Lincolntown Little River Logan Long Beach Longwood Lotla Lowell Lowesville Lucia Lumberton Marietta Marshville Marston Marvin Masons Cross Matthews Maxton McAdenville McDonald McFarlan Mill Springs Mills River Mineral Sprs Mint Hill Mollie Monroe Moorseboro Morven Mount Holl Mountain Home Nakina New Salem Newell Norman Norton Oceal Isle Beach Old Dock Old Hundard Olive Branch
Olympic Osborne Otto Patterson Spgs Peachland Pee Dee Pembroke Pinebluff Pineville Pinehurst Pireway Polkton Polkville Proctorville Purvis Raeford Raemon Ranlo Raynham Red Springs Reepville Rennert Rockingham Rosman Rowland Ruth Rutherford Saluda Sapphire Scaly Mountain Seaside Shallotte Shannon Shelby Sidney Skyland Southern Pines Spindale
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
Stallings Stanley Stubbs Sunset Beach Sunset Harbor Sunshine Supply Tabor City Thermal City Thomasboro Crossrd Timberland Tyron Tuckasegee Tuluca Tuxedo Unionville Waco Wade Mills Wadesboro Wagrum Wakulla Washburn Waxhaw Webster Weddington West Haven Westminister White Store Whitesville Wingate
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South Carolina Medicaid Service Area: Georgia Airline Alaman Alexander Amity Appling Augusta Baldwin Batesville Blichton Bloomingdale Blythe Boneville Bowersville Bowman Boydville Brooklet Canon Captoia Carlton Carnesville Ceder Rock Chennault Clayton Cleveland Clyo Comer Cornelia Danburg Dearing Demarest Dewy-Rose Dillard Dover Eastanolle Eden Egypt Elberton Ellabell
Enterprise Evans Falls Farmdale Fortsonia Franklin Springs Garden City Girard Gracewook Grovetown Guyton Habersham Hardwicke Harlem Hartwell Helen Hephzibah Hilltonia Hollingsworth Hollywood Inger Isle of Hope Kaysville Kenna Keysville Kildare Lake Mountain Lakemount Lanier Leaf Leefield Lewiston Lavonia Lincolnton Little River Marlow Martin Martinez
Meldrim Metasville Middleton Midway Millen Millhaven Mount Airy Mountain City Munnerlyn N. Elberton Nesta New Clarksville Newington Nubery Ogeechee Oliver Perkins Phinizy Pineora Pine Mountain Point Peter Pollards Corner Pooler Port Wentworth Rabon Gap Rayle Reed Creek Richmond Hill Rincon Rocky Ford Rosemont Royston Ruckersville Saint-Clair Sandtown Sandy Cross Sardis Satolah
Sautee Savannah Scarboro Shawnee Skidway Island Springfield Statesboro Stillwell Stilson Sylvania Tallulah Thomasboro Thomaston Thomson Thuderbolt Tignail Toccoa Turnerville Tusculum Tybe Island Unity Vanna Vernenburg Washington Waynesboro Wiley Windsor Windfield Woodclift Woodland Zeigler
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Note Types Defined DIR (Location Specific)
TP Comments (Entire Trip)
Trip Notes (Specific Trip)
Rider Notes (Permanently on account)
Seen by the Transportation Provider (Do not enter any personal information in this field) Examples: Directions to the residence, Doctors Name and Phone Number Seen by the Transportation Provider Example: Assistance Type (curb to curb/door to door/hand to hand), Height and Weight, Cane, Walker, Oxygen NOT Seen by the Transportation Provider Only seen by ModivCare Employees Examples: Reason for Urgent Trip, Member confirming a reservation, Gas Reimbursement Driver Name NOT seen by the Transportation Provider Only seen by ModivCare Employees Examples: Information regarding specific handling of a member, Preferred Transportation Provider, and Restrictions South Carolina CSR should only add these 2 exceptions to the Rider Tab: Change of Address Gas Reimbursement Driver taking more than one person to the same location
Service Animals When a member calls in to schedule a reservation and mentions a service animal, please ask the following 2 clarifying questions to confirm the animal is indeed a service animal: Is the dog or service animal required because of a disability? What work or task has the dog or service animal been trained to perform? If YES and Explains Task: - Complete reservation as usual - Add Rider Note stating a service animal travels with the member Do not ask the individual questions about the disability Do not ask the member to show license, certificate, or special ID card as proof of the animal training If NO or UNWILLING to provide details about the services performed: - Escalate the call to a Lead or Supervisor, who will then consult with legal direction
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Urgent Trip Verification What makes a trip Urgent? A reservation is considered Urgent when a members’ treatment cannot be delayed and a physician must treat the member the same day or the next day. Urgent Trip that DO NOT Require Verification Dialysis
Radiation
Chemotherapy
Wound Care
Discharge – ONLY done by facilities (facility calling facility assistance line)
Out Patient Surgery – in hospital only
How to handle Urgent Request If trip is LESS than 3 business days’ notice and NOT Urgent: Educated member on 3 business day notice policy and offer alternatives (gas reimbursement) If the member pushes back: Ask member: “If I were to call the doctor’s office now, would they confirm that your condition will worsen if the appointment is rescheduled within the required advanced notice?” o If YES: Place the trip into PENDING VERIFICATION and advise the member it will be verified. o If NO: DENY the trip using the reason “lack of proper notice”
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Cancellation Same Day/Next Day If a member calls in and needs to cancel an appointment for the same day: Ask the member the reason for the cancellation Advise the member “Thank you, Mr./Ms. (member’s name.) I will get this reservation cancelled for you and let transportation know you no longer need your ride.” BEFORE you cancel it in the system, call the TP and make them aware of the cancellation. When TP has been advised, cancel the trip and enter the appropriate note on the trip under “Cancellation Note” If a member calls in and needs to cancel an appointment for the next day or following day (NOT within 3 business days): Ask the member the reason for the cancellation Advise the member “Thank you, Mr./Ms. (member’s name.) I will get this reservation cancelled for you and let transportation know you no longer need your ride.” Cancel the trip in the system using the appropriate reason and call TP to make them aware of the cancellation. After TP has been advised, enter the appropriate note on the trip under “Cancellation Note” If a member calls in and needs to cancel an appointment within our 3 business days: Ask the member the reason for the cancellation Advise the member “Thank you, Mr./Ms. (member’s name.) I will get this reservation cancelled for you.” Cancel the trip in the system using the appropriate reason. (TP does not need to be called) Enter the appropriate note on the trip under “Cancellation Note” Most Common Reasons for a Trip Cancellation: o Appointment Rescheduled o Rider is Sick o Rider Transported by Family Member or Friend o LogistiCare Mistake
*If you are canceling just ONE leg of a trip, make sure you have clicked the correct one and are active on that specific leg. Whichever leg you are actively on is the leg that will be cancelled!
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Trips NOT Authorized (Denied) If the member/caller does not have all the information you need to complete the reservation (facility address and phone number), reservation will be DENIED due to INCOMPLETE INFORMATION.
“Based on the information you have provided, this trip is being denied due to…” Please only use the appropriate reason for denying a trip. Most common denial reasons are: INICM- Incomplete Information/Documentation NCS- Non Covered Service NOT3- Lacks 3 Day Notice
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Transporting COVID-19 COVID-19 TESTING: COVID-19 testing transportation requests are only covered when: The member is not currently symptomatic for COVID-19 and can safely participate in a shared-ride program. In conjunction with pre-operational testing. As a standard procedure before a medical appointment to ensure the safety of all patients. The testing site is an enrolled Medicaid SC DHHS Provider If the testing site is free and not being billed to Medicaid, DENY the trip as NCS- Non- covered Service. ** Drive Through: NOT COVERED** MEMBER COVID-19 POSITIVE: If the member has tested POSITIVE for COVID-19 or pending a test result for COVID-19 or symptomatic and traveling to a basic trip type: Offer Gas Mileage Reimbursement as an alternative. If the Member selects Mileage Reimbursement, schedule the trip as normal. If the Member states they do not have a friend or a relative to transport them: Deny the trip as Possibly Infectious. Inform Member we must have a NEGATIVE test result on file before we can transport them to/from appointments again. Enter a trip note explaining why the request was denied. (example: Member states they tested positive for COVID-19 on xx/xx/xxxx) ** It is NOT an approved service to transport Members to routine appointments or testing who are symptomatic, positive for COVID-19 or awaiting test results.** If the member has tested POSITIVE for COVID-19, pending a test result for COVID-19 or symptomatic and traveling to a URGENT TRIP TYPE (Dialysis, Chemo/Radiation, Wound Care, Out Patient Surgery): Schedule the reservation LOS: BLS (basic life support) Treatment Type: Possibly Infectious RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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COVID-19 Vaccination When a member calls in to schedule a COVID-19 Vaccination, please use the following steps: o Verify the member has an appointment time o Schedule the reservation as normal (Treatment Type: COVID-19 Vaccination) o Place reservation into PENDING VERIFICATION. (NOT PENDING COVID-19) o Add a Trip Note: “Member is going for COVID-19 Vaccine. Please verify the facility is administering the vaccine.” o Save
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Dual Eligible Stretcher Trip ** Dual Eligible: Member has Medicaid and Medicare
If a member calls in and requires to travel by stretcher, please follow these steps: 1. Click “Rider Tab” 2. Click “Alt Insurance” - Check for Medicare “SC MCO Provider” 3. Click “Forms” - If there is a letter on file, it should state the type of stretcher 4. Schedule the reservation based off TREATMENT TYPE and LOCATION NOT Dual Eligible Dual Eligible – Normal Trip Type (not hospital services or dialysis)
Dual Eligible – Urgent Trip Type o Hospital Services (surgery, wound care, cancer treatments, discharges) o Dialysis Exception: - Wound Care NOT in Hospital - Cancer Treatment NOT in Hospital (Medicaid will cover this)
Schedule reservation as normal Schedule reservation as normal Schedule reservation as normal Save D. E. N. Y (member has Medicare part B) Give the reference number to the member Reference Number is now a Denial Number Advised the member to take the Denial Number to an Ambulance Service of their choice and MEDICARE will cover the trip, NOT MEDICAID. (Medicaid is a payer or last resort)
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Linking and Cross Referencing When a member calls in to schedule a trip for themselves and another member to RIDE TOGETHER or for different children to RIDE TOGETHER, please use the following steps: 1. Start the setup for a normal round trip reservation 2. When the reservation is complete, save the reservation and pull up another reservation screen. 3. Make the second reservation. The APPOINTMENT TIME and B-LEG PICK-UP TIME will have to be the SAME. Save. 4. Once both reservations have been saved, enter RESERVATION NUMBER for the opposite reservation into the TP COMMENTS Example Reservation 1: 12345 Reservation 2:67890
TP Comments Link with Ref#: 67890 Link with Ref#: 12345
Entering Complaints When entering a complaint, please use the following format: ** This can also be found on the Agent Assistance Resource Note Template**
C (Caller) S (Subject) N (Notified) R (Response)
Document the caller's name, title, phone number, and time of call. Document the caller's inquiry or issue, scheduled pick-up time, and appointment time. Document who the transportation provider is and also notate which dispatcher you spoke with and what their response was. Document your response to the caller's inquiry or issue. Evaluate your response to ensure it is appropriate and get feedback from the speaker that they are comfortable with your solution.
Example C (Caller) S (Subject) N (Notified)
R (Response)
Bart Simpson (member) called at 11:30 from 864-111-1111 Bart stated the Transportation Provider did not show up for his 11:00 aleg pickup Called Transportation Provider, Southeast, and spoke with Sarah the dispatcher who stated the driver went to the home, waited, and the member never came out Informed Bart of the driver who came out at 9:40, waited until 9:50, but then had to leave since Bart did not come outside
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Lyft Trips If a member calls in to Activate a B-Leg “Will Call,” please use the following steps: Verify HIPAA as usual On the B-Leg, change the FACILITY PHONE NUMBER to the MEMBER’S PHONE NUMBER (this is the number the driver will contact) Put a Pick-Up Time for THREE MINUTES AFTER the member calls in. (It only takes dispatch 3 minutes to receive a trip) Advise the member a driver will be there in 15-20 minutes ** There is NO number to call for Lyft. You have to give information based on Circulation**
If a member calls in and states the driver never showed up, please use the following steps: Verify HIPAA as usual Check Circulation - If Circulation says “No Drivers Available” you must: Cancel out the trip Add a Trip Note Rebook the trip – assigning it to Lyft Healthcare - If LCAD says “Verified-Paid” and the member is still waiting (meaning Lyft picked up the incorrect person) you must: Cancel the initial trip File a complaint on Lyft Book a new reservation - assigning it to Lyft Healthcare. - If LCAD shows the trip “Cancelled” (completely grayed out): Check the audit trail to see the reason for the cancellation. The reason will determine if a new trip can be rescheduled or not. Each Lyft case is a case by case scenario. If unsure, please reach out to your Lead or Supervisor for clarification.
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Facility NOT in Rolodex When a member is scheduling a reservation and gives an address that is NOT in the system, please follow these steps: 1. Ask the member if they have been to that specific location with us before If YES: “fac” and “alt up.” A list of facilities that are not in the rolodex that the member has been to with us before should be listed. If NO: Go to Google and verify with yourself that it is a real address to a medical facility Gather all the needed information from the member and place the trip into PENDING VERIFICATION. Once assigned to PENDING VERIFICATION, use your Agent Assistance Resource: Verify Quick Notes and notate the trip appropriately.
Residential Address different than in LCAD When a member calls in to schedule a reservation, and they are giving a different residential address than what is on file, please do the following: - Check the rider notes for an address change - Check the Contact Info tab under Rider tab to see if Medicaid has updated it - If there are No Notes and the Contact Info is not updated, ask the member if they have recently moved and if it is a permanent address. (meaning they will be there more than 30 days.) If YES: Please change the address on the TRIP and advise them they will have 30 or 45 days (depending on insurance) to update their address. Add Rider Note. If NO: Please advise the member we can only pick them up from the address on file. - If the member has been advised of the address update, but has yet to do so, they will not be able to schedule a reservation until it is changed. RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Scheduling Eye Reservations When a member calls in to schedule a reservation to an eye appointment, ALWAYS check the following information: o The Member’s Age o The Member’s Insurance Plan If the member is UNDER 21:
o Schedule the reservation as usual
If the member is 21 OR OVER and only has SC DHHS:
o Ask: “Have you been diagnosed with a condition of the eyes such as: - Cataracts - Glaucoma - Diabetes (Retinal Disorder, Pink Eye and Macular Degeneration are also conditions) o If the member answers YES: - Schedule the trip as usual - Add trip note indicating the members condition - Does NOT need to go into Pending Verification o If the member answers NO: - Deny Trip - Add Trip Note
If the member is 21 OR OVER and has a National Account (like United or Humana):
o Please refer to the Universal Agent Guide to verify it is a covered service o You can also refer to the SOW on the sidebar of LCAD o Add Trip Note accordingly **Most National Accounts Cover Eye Appointments**
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Scheduling Dental Reservations When a member calls in to schedule a reservation to a dental appointment, ALWAYS check the following information: o The Member’s Age o The Member’s Insurance Plan If the member is UNDER 21: If the member is 21 OR OVER and only has SC DHHS:
If the member is 21 OR OVER and has a National Account (like United or Humana):
o Schedule the reservation as usual o Schedule the reservation as usual o Place into PENDING VERIFICATION (this is due to the fact that members have a $750 limit and we do not have documentation stating how much they have used) o Add a Trip Note stating the reason for the appointment o Please refer to the Universal Agent Guide to verify it is a covered service o You can also refer to the SOW on the sidebar of LCAD o Add Trip Note accordingly **Most National Accounts Cover Eye Appointments**
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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Unable To Reach Transportation Provider “Will Call” Activations When a member calls in to activate a “Will Call” and you cannot reach the Provider, please do the following: o Attempt to call the Transportation Provider again (you also have secondary ‘after hours’ numbers) o If you are still unable to reach TP after 2 attempts, please gather the following information and EMAIL it to your LEAD: The state the member is calling from Member’s Trip Number Date of the Appointment Reason for calling TP (example: Activate B-Leg) o Notate trip under “Trip Notes” with specific details of what occurred, including that it was escalated to a lead. (Use Agent Assistance Resource – Will Call Note Template)
A-Leg / B-Leg Pick-Up If a member is calling in for a scheduled A-Leg / B-Leg Pick-Up time and you are unable to reach TP: o If the member is still within the 30 minute window: Make 2 attempts to call the Transportation Provider If TP still does not answer, advise the member to call back once the time frame has expired. o If the 30 minute window has expired: Make 2 attempts to call the Transportation Provider If you are still unable to reach TP after 2 attempts, please gather the following information and EMAIL it to your LEAD: - The state the member is calling from - Member’s Trip Number - Date of the Appointment - Reason for calling TP (example: Activate B-Leg) o Notate the trip under “Trip Notes” with specific details of what occurred, including that it was escalated to a lead. (Use Agent Assistance Resource – “Where’s My Ride: A/B-Leg” Note Template)
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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If You Are Unable To Hear The Member When a member calls in and the line is completely silent: Repeat: “Good Morning/Afternoon, thank you for calling ModivCare. My name is ________. Would you like to schedule a reservation? If the line is still silent: Hello? (TWICE) If still no response: “CSR disconnecting due to no response.” When a member calls in and the member goes quiet during the call: Say to the member: Hello? Mr./Mrs. Are you still there? If still no response: “If you can hear me, please give us a call back and we will be happy to keep assisting you. Thank you for calling ModivCare.”
If the member asks to place you on hold to gather additional information: Advise the member/caller you can hold for one minute. If the member places you on a hold for more than one minute and they are not responding OR do not have the information available, please provide the following statement: Mr./ Mrs. (member’s name) I have reached the maximum hold time limit, and I cannot hold any longer. If you could please give us a call back when you have all the information, we would be happy to keep assisting you. Thank you for calling ModivCare and you have a great day.”
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Rider No Show Policy Rider No Show
Reification
1st No Show
Warning Letter #1
2nd No Show
Warning Letter #2
3rd No Show
Warning Letter #3
4th No Show
10 Day Suspension of Transportation Services
5th No Show
30 Day Suspension of Transportation Services
6th No Show
60 Day Suspension of Transportation Services
**Rider No Show Letters will be uploaded into LCAD**
RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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RESPECT • TRUST • RELIABLE • COMPASSION • SAFETY • TRANSPARENCY
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