Advanced Communication Enhancement

Communication Aptitude Test

CAT CENTER
ASSESSMENT GUIDE

Universal Handout
2022

Knowledge base is intended to assist applicants who will go thru the CAT Assessment, and that
information such as; physician name, healthcare plan, available programs, drug prices, and
insurance information were solely conceptualized for the assessment and that none of the
information is true and verified.
 Guidelines and Scenario Description
Scenario Summary
You are to play the role of United Healthcare advocate
receiving inquiries from members/providers about the
account. You are expected to probe for the reason of the
customer's call and provide requested information based on
the member profile data provided. During the call simulation
you are expected to:
Guidelines
Assist the member using the member profile provided.
During the Call Simulation make sure to:
Start the call by introducing yourself and
1 the company you represent.
2 Establish rapport and show courtesy.
Express empathy and/or compassion
3
whenever necessary.
Provide clear details, Instructions and
4 options to your member.
Please complete the following steps
SCENARIO:
1. Caller Verification
▪ Confirm if you are speaking with the account holder.
▪ If speaking with the Emergency Contact person, be sure to take note of
their complete name, relation to the member and at least 2 of any of the
following Information (Member ID, Member's complete name, Date of
Birth, Email or Address).
2. Provide Benefit Details
Probe for details to confirm the type of Medical Assistance or
Benefits the caller is entitled to based on their Health care plan.
Obtain required information from the caller when required.
3. Provide Clear Details and Instructions
▪ Hospitalization: provide coverage details and check if desired hospital
is covered as a partner or non-partner facility. *Any facility provided by
the member that is not on the list will be considered as a non-partner
facility.
▪ Office Visits: Include Medical check ups and requests of
prescriptions.
▪ Letters of Authorization: A guarantee letter from UHC that the
member's medical expenses will be covered.
4. Recap and Close the Call.
Provide a brief summary of what transpired during the call. Brand
your closing spiel.
Tips: Make sure to exhibit the following skills:
Active listening: Listen to understand and verbally
acknowledge the member's concern. Listen for cues for
empathy and compassion and respond accordingly.
Probe: Ask appropriate and necessary questions
Thought organization: Present steps and information in
a logical manner. Make sure to show coherence by
responding with relevant answers to the member's
questions.
Speak Clearly: Make sure you enunciate well and be
mindful of your pace, tone and choice of words.
Feel free to ask your Recruitment Specialist
or your CAT Assessor for assistance and clarification.
Definition of Terms:
▪ Member – patient
▪ Provider – hospital, clinic and healthcare
professionals providing health services
▪ Plan Type – plan coverage
▪ Primary Care Physician – first contact doctor
▪ Emergency Contact – person to contact in a
medical emergency
▪ Partner Pharmacies – for medication supplies
and possible discounts
▪ Monthly Premium – monthly plan price
▪ Current Balance – current charge amount
▪ Past Due – unpaid amount
▪ NPI – National Provider Identifier
 Member Assistance Dashboard

Member Information Plan Coverage

Member Name: Plan Type: Silver Premium Primary Care
Insurance Provider: United Healthcare
Physician
Image
Age:
SP Policy Number: 265-747-7
Policy Date:
05/01/2015 Status: Active Dr. Dani A. Moonstar, MD

NPI: 362851850
Contact Information
Phone Number:
Billing Information Phone number: 909-317-999
(814) 733 5456
Billing Summary Payment
Email Address: Information Email: d_moonstar_PHD@uhc.com
no available data Monthly Premium $280.00
Credit card no.
Home Address: Address: 565 N. Mt. Vernon Ave.
Current Balance $280.00 **** **** **** 1457
1775 John McClane Avenue
Manifold, CA 92405 Arcana, California, 92411
Past Due Amount $0 Automatic Payment: YES
Emergency Contact:
no available data

Definition of Terms:
▪ Member – patient
Drug Name Drug Type Quantity & Limit Total Price Partner
▪ Provider – hospital, clinic and healthcare professionals Pharmacies
providing health services
Mefenamic Acid Pain Killer 7 tabs • 1 tab per day for 7 days $5
▪ Plan Type – plan coverage
▪ Primary Care Physician – first contact doctor
• Walgreens
▪ Emergency Contact – person to contact in a medical Losartan Hypertension 30 tabs • 2 tabs per day for 15 days $12 • Rite Aid Corp.
emergency
• Safeway
▪ Partner Pharmacies – for medication supplies and possible DRUG &
discounts
MEDICATION Metformin Diabetes 60 tabs • 2 tabs per day for 30 days $10 • Costco Pharmacies
▪ Monthly Premium – monthly plan price
▪ Current Balance – current charge amount
▪ Past Due – unpaid amount
▪ NPI – National Provider Identifier IMPORTANT:
Submit medication order for Home Delivery Store Pick Up Home Delivery, please expect medication to be delivered within 24 to 48 hours