Basic Streamline Knowledge Assessment_december 2012

12 Questions | Attempts: 64
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Assessing CSR Streamline Knowledge (Basics)


Questions and Answers
  • 1. 
    How can a CSR get the narratives to auto-populate on Streamline interactions?
    • A. 

      A. Document all calls on the second instance of Streamline you open.

    • B. 

      B. Click on the tab you wish to document on, leave this tab, and return to document.

    • C. 

      C. Select the appropriate tab on the lower half of the screen, selecting the “New Task” button.

    • D. 

      D. Click the “auto-pop” radio button in settings.

  • 2. 
    To properly update the member’s address in Streamline, be sure to use only:
    • A. 

      A. Family Address 0

    • B. 

      B. Family Address 2

    • C. 

      C. Family Address S

    • D. 

      D. Member Home

  • 3. 
    What 2 areas must BOTH be confirmed when working with a Personal Representative in Streamline?    **NOTE: If this note is not in both areas, call the Assist to have Enrollment verify this
    • A. 

      A. Related Notes & HIPAA Tab

    • B. 

      B. Authorized Rep Tab & Intake History

    • C. 

      C. HIPAA tab & Intake History

    • D. 

      D. Authorized Rep & Related Notes

  • 4. 
    Which of the following 2 areas can be checked to ensure that you are not creating a duplicate grievance?      1.  Call History – to ensure that the member has not called on the same issue within the same                                     calendar month      2.  Benefit Summary – Verify the reasons that grievances don’t need to be duplicated under the                                               Grievance section      3.  Appeals History – Check to see that a duplicate grievance for the same issue is not being                                             filed within the same month      4.  Complaint Summary – Right click on the Complaint Tab to view member complaint history
    • A. 

      A. 1 & 2

    • B. 

      B. 1 & 3

    • C. 

      C. 1 & 4

    • D. 

      D. 2 & 3

    • E. 

      E. 2 & 4

    • F. 

      F. 3 & 4

  • 5. 
    To update a closed intake, CSRs must do the following:
    • A. 

      A. On the Task Note box on the Edit Call page, the last note entered will display. To edit existing notes, make corrections as needed. If you are simply adding additional information, delete all notes in the “Notes” section and type only additional notes, then click Save.

    • B. 

      B. Create a new intake, and review Call History. On this tab, there will be an edit button that will allow you to pull any existing notes for editing. If you don’t need to correct anything with the last note entered, you can delete the information and only add the needed information, then click on any other Tab to save.

    • C. 

      C. On the Task Note box on the Edit Call page, the last note entered will display. Type whatever information you want to replace the existing note, then click Save.

    • D. 

      D. Email the Streamline email box with details of the intake and what needs to be updated, and Streamline will replace these Task Notes.

  • 6. 
    When filing a manual grievance (i.e. Trying to save a task note and after clicking the Grievance check box Streamline returns the message “Grievance description is required.”) You must complete the following two fields on the Add Grievance tab.
    • A. 

      A. Description (Desc.) = Copy and Paste Summary Notes

    • B. 

      B. Summary = Copy and paste the task notes

    • C. 

      C. Note= Copy and Paste the Summary

    • D. 

      D. Note = "Task Notes" (type in these words)

  • 7. 
    T/F:  It IS NOT an acceptable to pend an intake related to grievances for future work?
    • A. 

      True

    • B. 

      False

  • 8. 
    The indication that a grievance needs to have a provider attached to it in Streamline is:
    • A. 

      A. The Providers tab will pop-up for completion

    • B. 

      B. The Providers tab in Streamline will turn red when required

    • C. 

      C. The Additional Information section of the Narrative will indicate this

    • D. 

      D. The End Call screen will not allow the Save button to be active until completed

  • 9. 
    What needs to be done when a task note is created, but the provider wasn’t attached as it should have been?
    • A. 

      A. On the End Call screen, enter the provider on the Provider Tab and click Save.

    • B. 

      B. Email the Grievance and Appeals Team with the intake and provider information to have this provider attached to the grievance.

    • C. 

      C. From the Call History tab of a new intake, click the edit link to add the provider to the Provider Tab.

    • D. 

      D. Escalate to the Assist to have this added in Facets.

  • 10. 
    Which of the following resources should be the primary resource for benefit details?
    • A. 

      A. The Narratives

    • B. 

      B. KME

    • C. 

      C. The Benefit Summary in Streamline

    • D. 

      D. The Benefit Grid on MySource

  • 11. 
    When Streamline is down, what should I do to assist callers?
    • A. 

      A. Apologize for the inconvenience, and advise members to call back at a later time.

    • B. 

      B. Facets trained CSRs are to document all calls using Facets. Streamline users are to assist members by using the pharmacy system to validate members.

    • C. 

      C. Place yourself into Systems so calls will be addressed only by Facets trained users.

    • D. 

      D. Tansfer members to the temporary queue that will be communicated that is staffed with Facets trained users.

  • 12. 
    Which of the following must be done to remove a grievance created in error? Click all that are correct.
    • A. 

      A. If the error is caught prior to ending the call the CSR should from the end call screen enter the “appeals tab and document in the appeal itself filed in error and the reason.

    • B. 

      B. If error is discovered after the call has been contact a Grievance and Appeals specialist to request that they remove this prior to the close of business so this will not be reported to the state on their pending transmission list.

    • C. 

      C. If error is discovered after the call has been ended the must go through the edit call screen and document grievance filed in error and the reason why in the task note.

    • D. 

      D. If the error is caught prior to ending the call access the grievance in Facets (or escalate to a Senior if you do not have Facets training) so that this grievance can be deleted.

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