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ODG Quiz

Authored by James Watson

English

1st Grade

CCSS covered

Used 91+ times

ODG Quiz
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20 questions

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1.

MULTIPLE CHOICE QUESTION

1 min • 5 pts

What are the 4 ODG Letters?

We do not have to send letters

-Contact Provider

-Contact PMG

-Contact Covered CA

-Missing Information on a Claim

-Contact Employer Group

-Contact Covered CA

-Missing Claim or Missing information on a Claim

-Missing information on Authorization

If we resolve the request the letter does not have to be sent.

2.

MULTIPLE CHOICE QUESTION

1 min • 5 pts

What Company Code applies to the California DMHC One Day Grievance Process?

200C

360C

368C

858C

3.

MULTIPLE SELECT QUESTION

1 min • 5 pts

What steps must be followed when a member is advised that their claim is not on file?

Select all that apply

Send applicable ODG Letter

Advise member to call provider and have them send the claim to us.

Reach out to provider or facility to request the resubmission of claim.

Transfer the caller to another rep to see if they have the information available.

4.

MULTIPLE SELECT QUESTION

1 min • 5 pts

What steps must be followed if a provider list is sent to the member?

Select all that apply

Create Provider Task in SC

Answer ODG Questions by selecting Provider not found/Emailed Directory

Attach list to SC

Go to Anthem.com directly to avoid opening the task in SC

5.

MULTIPLE CHOICE QUESTION

1 min • 5 pts

What required step must be followed if a member calls and needs Interpretation Services?

Ask the member if they would like to update their preferred written or spoken language.

Transfer the member to the designated language line

Determine if the type of issue really needs an interpreter.

Transfer member to your supervisor for help.

6.

MULTIPLE CHOICE QUESTION

1 min • 5 pts

What must be done if you are trying to complete an interaction and a system issue prevents closure of your One Day Grievance?

Close the work item and leave on dashboard, it will close itself overnight

Cancel the work that is preventing you from completing your call.

Reach out to support chat to receive assistance in closing the item same day

Ignore it, the system will handle the issue.

7.

MULTIPLE SELECT QUESTION

1 min • 5 pts

How must the ODG be documented if a member calls about a past interaction or grievance?

Tag the prior Interaction or Grievance within the ODG

Transfer the call to the previous associate and log your interaction as an inquiry

Select the Repeat Contact Indicator and link the prior interaction to yours

Document the ODG as an Inquiry because there is no current problem only a previous one.

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