Not In SSC Process

If a floor rep chats in without all of the information needed to search for a record send this canned response:

Canned Response

When you cannot locate a participant in the SSC, include the participant’s first and last name, the last four of their SSN, zip code, date of birth, and client. InfoSource needs this information to correctly search for a record.

Ask the following questions to verify a participant's situation:

Are they Medicare eligible?
Are they losing group coverage?
What is the reason for their call?
When did they retire / what is their retirement date?
How did they get the Via Benefits number?

If you are unable to locate a record for the participant and you have determined they will be transitioning within the next 3 months, verify the client guide procedure for not in SSC and send the corresponding canned response.

CSR

Pega Case Only	Canned Response I was unable to find the participant in the SSC, please create a record for them following the Creating an SSC Record and SSC Record Basics speed sheets: https://portal01.extendhealth.com/SitePages/Resourceartifact.aspx?RedirectID=RCDIN070 https://portal01.extendhealth.com/SitePages/Resourceartifact.aspx?RedirectID=RCDIN312 Since the Client Guide states a “Not in SSC Case” is necessary, you will need to create the “CID Not Found” Pega case to the data team. Once the record is created please transfer to a BA to look at enrollment options.
Pega Case and Warm Transfer	Canned Response I was unable to find the participant in the SSC, please create a record for them following the Creating an SSC Record and SSC Record Basics speed sheets: https://portal01.extendhealth.com/SitePages/Resourceartifact.aspx?RedirectID=RCDIN070 https://portal01.extendhealth.com/SitePages/Resourceartifact.aspx?RedirectID=RCDIN312 Since the Client Guide states a “Not in SSC Case” is necessary, you will need to create the “CID Not Found” Pega case to the data team. Once the record is created please transfer to a BA to look at enrollment options. This client also requires a warm transfer to the benefits center. Here is the number--
Warm Transfer Only	Canned Response I was unable to find the participant in the SSC, please create a record for them following the Creating an SSC Record and SSC Record Basics speed sheets: https://portal01.extendhealth.com/SitePages/Resourceartifact.aspx?RedirectID=RCDIN070 https://portal01.extendhealth.com/SitePages/Resourceartifact.aspx?RedirectID=RCDIN312 This client only requires a warm transfer to the benefits center, not a Data case. Here is the number--
No Case or Transfer Needed	Canned Response I was unable to find the participant in the SSC, please create a record for them following the Creating an SSC Record and SSC Record Basics speed sheets: https://portal01.extendhealth.com/SitePages/Resourceartifact.aspx?RedirectID=RCDIN070 https://portal01.extendhealth.com/SitePages/Resourceartifact.aspx?RedirectID=RCDIN312 This client does not require a Data case or a warm transfer to the benefits center.

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