GALAXY QUIZ v2

CTM GALAXY

game

Start

start

Please ensure that the video on each slide is played, and then proceed to answer the question corresponding to each scenario.

Activity Instructions:

Option C

Scenario 1: "I need a specific medication, but it's not covered by your plan. What should I do?"

Option A

Option B

01/10

Press Play to view the video.

01/10

Press Play to view the video.

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

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."

01/10

02/10

Press Play to view the video.

"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."

02/10

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

03/10

Press Play to view the video.

"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."

03/10

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

04/10

Press Play to view the video.

"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."

04/10

Scenario 4: "I enrolled in your plan last year, but I felt the benefits were not explained properly. How do I know this will not happen if I enroll in one of your plans again?"

05/10

Press Play to view the video.

05/10

"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."

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

06/10

Press Play to view the video.

06/10

"I apologize for the inconvenience. Let me get an interpreter on the line for you.."

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

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

Scenario 6: "I am having difficulty understanding this plan because of the language barrier. What should I do?"

07/10

Press Play to view the video.

07/10

"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."

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

08/10

Press Play to view the video.

08/10

"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."

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

09/10

Press Play to view the video.

09/10

"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."

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?"

10/10

Press Play to view the video.

10/10

"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 understand your concerns. I will review and help you compare the copays for all Tiers. If you have any medications in mind, I can also look them up to confirm if they are covered."

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?"

You are a star!

You may continue back to your course.

Wrong!

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

Great job!

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

Way to go!

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

You've got great steering skills!

By acknowledging the member'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!

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

Let's keep it going!

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

We're almost home!

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

You're a PRO!

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

Great job!

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

Almost there!

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

You have completed the journey!

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