TYPES OF CALLS

1. MEMBER

1.1. Complains, Appeals and griveances

1.2. Manage auxiliary persons

1.3. Send Non-marketing materials

1.3.1. PDP anual notice of change EFT Form ID Card replacement LIS Gain/Qualify for subsidy Payment envelope PBM Claim form Pharmacy director Replacement COB form Replacement evidence of coverage Replacement formulary listing Replacement kit Replacement mail order form SSA Deduction form Welcome kit Replacement certificate of coverage

1.4. Send secure email

1.5. Update member profile

1.5.1. Update DOD

1.5.2. Activate secure email

1.6. Update member address

1.7. Send informative email

2. BILLING

2.1. Check received by member

2.2. Establish repayment plan

2.3. General billing questions

2.4. Manage LEP

2.5. Make a payment

2.6. Premium payment discrepancy

3. ENROLLMENT

3.1. Enroll/Disenroll a member

3.2. Reinstate a member

4. PHARMACY

4.1. EOB

4.2. Claim history

4.3. Drug costs estimator

4.4. Drug lookup

4.5. Formulary lookup

4.6. Find a pharmacy

4.7. Coverage stage

4.8. Rx home delivery

4.9. Review Rx benefits

5. GENERAL

5.1. Compassion and Embrase

5.2. Transfer to advocate

5.3. Escalate to supervisor

5.4. General service request

5.5. Web issues

6. PLAN

6.1. Educate DMR

6.2. Medicaid coverage

6.3. Review medical benefits

6.4. Update member LIS

6.5. Update member COB

7. APPLICATION

7.1. Change plan

7.2. Review application status

7.3. Update applications