
CAO | Outsourcing Provider Approval
Quiz by Sheena Jane Tioc
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What does CAO Mean?
What are the two kinds of Outsourcing Approval Calls?
What is the scope and duty of a CAO Representative?
Who will provide the list of cases?
What will you do whenever the member/provider we are speaking does not speak English?
It is the representatives responsibility to provide the approval information in a clear and accurate statement.
It is the responsibility of the representative to not document the call after notifying the approvals.
This is a tool that is used in dialing the provider or the member.
This tool is used to look for the approval and all the information which you will provide to the provider/member.
This tool is used when you will need assistance to translate in another language.
How many minutes is the timing for the 2nd attempt?
How many member data points should we at least provide to our providers?
When reaching the provider for an approved authorization, how many can we provide at a time?
What is the provider services phone number?
What is the name of the company?
How do we document an exempt call?
How can we say that the call that we had with the provider was successful?
What is the Provider Portal?
Documentation can only be used if the provider agrees to obtain the authorization information and SA was able to provide the authorization information completely.
CDocumentation can only be used if the provider requested if we could fax the authorization or state that they will check it in the web/portal.
CDocumentation can only be used if the provider states that they already received the authorization or they already checked it in the portal.
CDocumentation can only be used if the call was routed to the provider’s voicemail and SA leaves a voicemail.
CWhat kind of attempt is this?
When we are unable to reach provider or phone is left to ring for at least 10 times with no VM (this includes when voicemail is full) – this would require 2attempts.
CWhat documentation should we use when in the middle of the conversation the call disconnected. When SA did a call back the provider cannot be reached (including no VM)
If the phone rang 3-5 times and the call disconnected.