Pharmacy - Purpose: This document provides process for Customer Care to handle pharmacy (Rx) calls., Eligibility - Purpose: Advocates educate our members via eligibility calls regarding COB, child support orders, primary care physician updates, and ID cards, Benefits Coverage - Purpose: This document contains processes related to benefits and coverage that address benefit questions, concerns, and dispute options., Proactive Member - Purpose: Provides Member Services Advocates with the processes to proactively engage members for appropriate opportunities., Provider Referral - Purpose: Use this document to assist and educate members with provider lookup, steerage, and financial benefits available., Financial Advocacy - Purpose: This document provides financial-related processes to Member Services Advocates., Building Trust - Purpose: This document provides Advocates processes needed to build trusting, lasting relationships with our members and callers., Claims Advocacy - Purpose: This document provides claims-related processes to Member Services Advocates based on advocate's current role., HIPAA Advocacy - Purpose: This document provides HIPAA-related processes to Member Service Advocates., Self Service - Purpose: This document provides process for mobile applications and self-service applications available to UnitedHealthcare member., COVID - Purpose: This document provides information and talking points regarding COVID-19., Notification - Purpose: Our policy is that our advocates provide our members with initial notification/prior authorization requirements, notification/authorization status, and member-specific benefits, including concerns and options for disputes., Appeals Complaints - Purpose: This document provides guidelines for handling and forwarding commercial consumer written and/or oral appeals, grievances, and complaints received in a Customer Care Center in accordance with applicable state and federal regulations., UHC Products - Product/Network/Plan Information , ISET - enables you to view a member's account, program eligibility, claims processing information and more., ICUE - Used to document refferals., Dashboard - Programs offered to members system, Be Familiar - The 1st guiding principles that make up the Advocacy Framework, Anticipate - The 2nd guiding principles that make up the Advocacy Framework, Guide - The 3rd guiding principles that make up the Advocacy Framework,
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تحرير المحتوى
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