Cavulus Manual. For External Agents

Transcription

1 2018 Cavulus Manual For External Agents

2 Table of Contents Welcome to Cavulus... 3 How to Login... 3 Home Screen... 3 Lead Entry and Starting an Application... 4 Duplicates... 4 Lead Source... 5 Lead Details... 5 Entering an Application... 6 Application Types... 7 Enrollment Form... 7 Uploading Scope of Appointment and Enrollment Form... 7 Update Page... 8 Sales Status... 8 Managing Sales Leads... 9 Looking up a Lead... 9 Permission to Contact and Future Eligibility Date... 9 Set Future Eligibility Date... 9 Follow-Up Dates...10 Setting an Appointment...11 Sales Status Definitions...11 Lead Screen Tabs

3 Welcome to Cavulus The Cavulus program is designed to assist in tracking the progress of all leads and enrollments to ensure they are properly assigned, managed and worked in the appropriate timelines. Depending on your Sales Organization, you will either send them your applications or you will enter them yourself. If you are entering them yourself you will need to review the section on how to enter an application. Either way, Cavulus is where all electronically submitted applications should be entered for processing by our Enrollment team. This system is available for you year round to manage your leads with our plans. QualChoice Health - HeartlandPlains Health - QualChoice Advantage - RiverLink Health - Soundpath Health - How to Login Once you have completed your training and are ready to start selling you will receive an from our Broker Relations team with your username, password, and link to the program you are appointed to sell for. The first time you log in you will be required to reset your password. If you forget your password at any time, please contact us at Broker.Relations@Qualchoicehealth.com to reset it. Home Screen Once you are logged in you will see this menu at the top of your screen. Lead Entry The lead entry function is where most incoming leads and applications are entered into the system. It captures all the information you will need to track and manage your leads. Lead Manager The lead manager gives you the tools you will need to examine and manage your existing leads, both individually and in groups. Enrollments The enrollment manager gives you statistics about enrollments, disenrollments and viewing a book of business. 3

4 Lead Entry and Starting an Application Lead Entry is where you start to enter a new application or create a new lead. When entering a NEW lead Complete the Following Fields: Language Preference First Name Last Name Phone Response Type (If the Lead Source Field and Name Fields do not auto populate information, Agent will need to manually enter the data) Duplicates If the lead is already in the system you will get a Possible Duplicate notice. Be careful not to create duplicates. Go BACK & SEARCH for the member. If you cannot see the person in the system, you will need to contact broker.relations@qualchoicehealth.com. It means another Agent may be assigned to the member. 4

5 Lead Source When you enter your leads into the Cavulus you will most likely select referral or broker when you are selecting how prospects heard about us. Broker - If the lead is self-generated by the Agent they will select this option. Referral Can be a member, relative, spouse, provider, etc. Lead Details After you fill in the lead information and source click on Continue. On the next screen - Complete the Following Fields: 1. Home Address (permanent address) 2. Zip Code 3. (Optional) 4. Date of Birth (Optional) 5. Are they Medicare A&B Eligible (Y/N) 6. Current Coverage 7. Do they have ESRD 8. What is their Consent Level 9. Add Notes on this page or after lead is saved 5

6 Entering an Application Now that the lead has been established in the system you can enter an application or make a plan change. When entering a new enrollment or a plan change you will go to Lead Manager on your top menu. REMINDER: Applications should be entered within 48 hours of receipt. If the prospect is currently in the system, you can go to the next step. If not, you will need to set them up as a lead first. (See Lead Entry and Starting an Application on page 4) Click on your leads name in the list of results. When you click on their named the summary page will come up you will click on Enrollment Form. 6

7 Application Types Select either Enrollment Form or Plan Change Enrollment Form Application is for a beneficiary that is not currently on the plan. Plan Change Beneficiary is wanting to change from the coverage they are currently on to another. (Soundpath Health and RiverLink Health Only) Enrollment Form Enrollment Form or Plan Change Accurately complete the following sections: 1. Medicare Advantage Plan Choice 2. Primary Care Provider (PCP) Information 3. Personal Information 4. Medicare Information 5. Please read and answer these questions 8. Payment Options 9. Enrollment Agreement 10. Attestation of Eligibility for an Enrollment Period 11. Digital signature Verify Agent information is correct and click Submit My Application once everything is filled out. Uploading Scope of Appointment and Enrollment Form Once you have entered the enrollment application you will need to upload the scope of appointment and enrollment form. Also include all supporting documents such as a paper check if your client has selected EFT for their payment option. To upload the documents you will need to scan them into your computer. Name them by the plan, member name, and year (example: SPH_AnnaApple_Enrollment_2018). When you are in the lead screen for the member click on the Upload Applications button and select your file, click on the Submit button, add a note, and then click Save. 7

8 Update Page Once a lead enrolls in the plan and becomes a member, the colors on the Members page will change. Instead of a yellow background in the Details Panel, the background is changed to a light lavender color. This lets you know at a glance whether a specific lead is already enrolled. Sales Status Once you submit an application into Cavulus, check back within two days to verify it was processed. Status should show - Ready for Export or Processed by Enrollment. Look in lead manager for the status to determine if there any incomplete applications. If the status is Incomplete, please do the following: 1. Read the note to see why the application is incomplete 2. Go in and make the change and or add the information 3. After saving go to the sales status bar and click on the Incomplete Resolved and enter a few words in the notes section 4. Then click SAVE Incomplete Enrollment Forms should be resolved within 48 hours. There is an exception for those who just signed up for Medicare and CMS has not verified their HICN number yet. We will hold those applications as incomplete for 21 days to allow for Medicare validation. Please continue to monitor the application until it is complete. 8

9 Managing Sales Leads Looking up a Lead Enter at least the first three letters of the Lead s first and last name. If the Lead Source Field and Name Fields do not auto populate information you, will need to enter a completely new lead. If you think your lead may already be in the system, you can search using the first and last name. Permission to Contact and Future Eligibility Date Permission to Contact This gives the Agent the ability to create the permission to contact the prospect. If a person does not want to be contacted, their lead should remain as Non-Consent. Set Future Eligibility Date The Future Eligibility date is the date when the lead will become eligible for Medicare Advantage plans. For example, three months before their 65th birthday, when their employer plan ends, or change of residence. The Eligibility date field has a calendar icon to its right. You enter a date by moving the curser to the right month and year, then clicking on the desired day on the displayed calendar. The change the month, use the arrow keys at the left and right of the heading bar. 9

10 After you click the Save button, the Medicare Tab will come back up with the Sales Status set to Future Eligible. ALWAYS set a follow-up date to appear on your calendar before you change the status to Future Eligible. Check your calendar to see if the follow-up appears. Follow-up Dates To set a reminder on your calendar to follow-up with your client at a later date you will click on Set Follow-up on the lead screen. You will then need to fill in the appointment time and date as well as add a note before you click save. To add the date click on the calendar on the right of the boxes and dropdown calendar will appear. Once you have saved your entry a note will appear below with the in the history section showing when your follow-up is scheduled. The date and time will also appear above the sales status. If you need to change your follow-up date or schedule another you will need to add a note and then click on the X next to date and time above the sales status. The system will then add a note in the history section that you have removed the follow-up. 10

11 Once it has been removed to set a new date by following those same steps again. Be sure you add your dates and times to the follow-ups. Setting an Appointment When booking an in person appointment to go over benefits with a beneficiary you will go into their lead screen and select Set Appointment from the row of links Per CMS regulations a Scope of Appointment (SOA) is required 48 hours prior to the appointment, when practicable. You will need to provide the date the SOA was obtained as well as set your appointment time and date. Include a note and click save. Sales Status Definitions 11

12 New Prospects Leads assigned as they are entered in Cavulus will show in this section. Pending Appt. Requests This is when an Agent enters a lead and changes the status to appointment. The Agents need to add a note in the lead as to when the in-home is scheduled. Once the Agent chooses set appointment and indicates the date and time, the lead will move to the appointment bucket and show on that Agent s calendar. Appointments Any in-home appointment that has been setup with the time and date will be reflected in this section and show on that Agent s calendar. Agents must have a Scope of Appointment and have documented in the designated area in Appointments. Follow-up Set your follow-up date here to contact the beneficiary. Agents should be sure they are setting follow-ups in a manner that they can meet. Commitments This status would be chosen for a beneficiary who has indicated they are enrolling and has committed to you as their Agent. For example, if a beneficiary has mailed in their application and you are waiting to receive it AEP Any beneficiary that requests information for the following AEP October 15 th - December 7 th. Future Eligible This is a lead that will not be enrolling for at least three months. Seminars Agents can see the number of prospects and members that have been booked into their seminars. Apps Rec d by Agent Applications processed by the Agent once entered in the system but have not been verified by enrollment yet. Incomplete Applications that are rejected by enrollment due to an error will show in this section. The Agent of record should rectify this error no later than 48 hours from it appearing here. Incomplete Resolved All resolved applications that have been corrected need to be marked Incomplete Resolved. That will notify the enrollment department that they can continue to process the application. Ready for Export Enrollments that have been audited by the enrollment team will show in this section. Processed by Enrollment An Agent s book of business (members assigned to them) is reflected in this section. Applications loaded into the enrollment system and sent to CMS. Declined Any time you change a lead s sales status to declined it will be in this section. Closed - When a lead status is changed to do not contact or deceased they will show in this section. 12

13 Non-Consent Leads that do not want to be contacted. Agents cannot contact anyone in this section by phone. They can only be contacted in writing. Possible Dupes Duplicate records that have been entered will appear here. We process this section daily. Enrollment Denied Applications denied by the enrollment department or CMS. Lead Screen Tabs When to enter notes/records into Cavulus A lead should be entered when an Agent has two identifiable pieces of information (name and/or phone, , street address, or zip code). Agents should enter a general note in the system each time contact is made with the prospect or member including a summary of the call. PTC History Whenever the Permission to Contact (PTC) is changed the PTC History tab will update who made the change and when. The deactivated date will only populate when that PTC is changed. Application History This tab will only show once an enrollment application is entered. The most current form will be in red. Transaction History You can see all of the CMS transactions with the enrollment application on this tab. Documents When you upload your SOA and enrollment form, you will see them here. All tabs are searchable with keywords and you can adjust how many historical entries you want to see at once. 13