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Common types of calls (Members (providing education on cover (private…
Common types of calls
Members
triggered by letter sent
PHIS/SIS
Tax Statements
online claim rejection
No reason provided as to why
Direct debit rejection
call to make a manual payment
no error messages with why it rejected
check annual limits
ortho claims
dental limits
checking eligibility
cover reviews
providing education on cover
private patient in public
medical claims, how they work
education on the system
increase health literacy
Provider
Following up payments
usually difficult to fix/answer
notes in HAMBS are shorthand and not easy to understand
Question the consistency of our rates
fund checks
seeing GMH and not knowing which brand it's for (ie Frank/BD/GMHBA)
STP claims gone wrong
Stuck in the system and doesn't go to Medicare
picks up the wrong info in the invoice
doesn't pick up connect rewards
2 way claims picking up 100% not 120%
Prospective Contacts
Frank webchats
approx 50% of volume