GALAXY QUIZ

game

CTM GALAXY

Start

01/10

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Scenario 1: "I'm interested in enrolling in your plan, but my current specialist doesn't accept it. What should I do?"

"I'm sorry to hear that. Maybe you should consider finding a new specialist."

"That shouldn't be a problem. You can continue seeing your specialist, and we'll cover the costs."

"Let me check if there are other specialists in our network who might meet your needs."

02/10

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Scenario 2: "I received your brochure, but it seems to have incorrect information about the plan benefits. Can you explain?"

"That's strange. I'm not sure why that would be."

"I'm sorry for any confusion. Let me provide you with accurate information about our plan benefits."

"I didn't create the brochure, so I can't help you with that."

03/10

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Scenario 3: "I spoke to one of your representatives, and they were very rude and unhelpful. What are you going to do about it?"

"I'm sorry to hear that. I'll make sure to pass on your feedback."

"Maybe they were just having a bad day. You should try calling back."

"That's unfortunate. There's not much I can do about it."

04/10

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Scenario 4: "I enrolled in your plan, but I'm confused about some of the benefits. Why wasn't everything explained properly?"

"I don't know. You should have read the documents more carefully."

"I'm not sure. Maybe you misunderstood."

"That's unfortunate. Let me clarify the details for you."

05/10

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Scenario 5: "Your brochure promised certain benefits, but now I find out they're not included. Why did you mislead me?"

"I'm not sure. Maybe there was a mistake."

"You should have read the fine print. There's nothing I can do."

"I apologize for the confusion. Let me clarify the benefits for you."

06/10

Scenario 6: "I'm having trouble understanding your customer service representative because of the language barrier. What should I do?"

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"I apologize for the inconvenience. Let me find a representative who speaks your language or arrange translation services."

"I'm not sure. Maybe you should try sending an email instead."

"I don't know. Maybe you should try calling back later."

07/10

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Scenario 7: "I just found out that my specialist doesn't accept the plan you recommended. What should I do?"

"You should continue seeing your specialist and pay out of pocket."

"Let me help you find another specialist within the plan's network."

"That's unfortunate. You might have to find a new specialist."

08/10

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Scenario 8: "I received incorrect information from one of your representatives. How will you fix this?"

"You should have asked for clarification."

"I apologize for the misinformation. Let me provide you with accurate information."

"I'm not sure. Maybe you misunderstood."

09/10

Scenario 9: "You told me this PPO plan has both in-network and out-of-network benefits. Will I have to pay more if I go to an out-of-network doctor?"

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You will always have to pay fully out of pocket for out-of-network services, and the plan will reimburse you.

Generally, you will pay more if you go to an out-of-network provider. I will review the copays for specific out-of-network services.

You will never pay more for an out-of-network provider.

10/10

Scenario 10: "You have told me of the medications I take are in Tier 1 and Tier 2. What happens if I am prescribed a more expensive medication?"

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I have no way of knowing the copay until you are prescribed the medication. You can call Member Services and they can check the price for you.

The copays should be similar to what we have discussed already, so you do not need to be concerned.

I will review the copays for Tiers 3, 4 and 5. If you have any medications in mind, I can also look them up to verify they are covered.

You are a star!

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Wrong!

Oh no! We've crashed into the CTM asteroids. Let's try again!

Great job!

Explanation: By offering to check for other specialists within the plan's network, you show proactive problem-solving and a willingness to address the client's concerns.

Way to go!

Explanation: By apologizing for the confusion and offering accurate information, you show responsibility and a commitment to transparency.

You've got great steering skills!

Explanation: By acknowledging the client's feedback and committing to passing it on, you show empathy and a commitment to addressing their concerns.

Great job keeping those CTM asteroids away!

Explanation: By offering to clarify the details for the client, you show a willingness to address their confusion and provide assistance.

Let's keep it going!

Explanation: By apologizing for the confusion and offering to clarify the benefits, you show empathy and a commitment to addressing the client's concerns.

We're almost home!

Explanation: By apologizing for the inconvenience and offering to find a representative who speaks the client's language or arrange translation services, you demonstrate your commitment to ensuring effective communication.

You're a PRO!

Explanation: By offering assistance in finding another specialist within the plan's network, you address the client's concern and provide a solution.

Great job!

Explanation: By apologizing for the misinformation and offering accurate information, you show responsibility and a commitment to addressing the client's concerns.

Almost there!

Explanation: Copays are usually more expensive for out-of-network services, and they can vary by plan.

You have completed the joruney!

Explanation: Agents should always present the copays for all Tiers even if the prospect does not take any medications in the upper tiers. If the prospect has the name of the medication, the agent should look it up to confirm it is covered.