University of WI-Stout

e-Learning Storyboard for Benefits 101

Unit #1: Identifying and Defining Basic Benefits Lesson #2: Differentiating Benefits

Font text used throughout: Arial, Arial Black. Font size used throughout: 36, 28, and 20

Color Schemes used throughout: gray background. Text: black, white, turquoise and pink
 Screen Text Audio Graphics Programming Notes
Info
ID: Benefits 101: Welcome to Benefits 101 Differentiating Benefits Woman on phone with computer at desk. Only navigation button shown
Ben1_2_010 is the forward arrow.
During this self-paced course, we will be defining basic and https://commons.wikimedia.org/wiki/File
Differentiating
T: Full Screen/ complex benefits and how we differentiate between them. This is :Health_professional_answers_questions Graphic placed on the left side
Title Page
Benefits _(1).jpg
an important piece in preparing you to provide basic benefit of the screen centered
information to our members when it is appropriate. horizontally.
H1: Title PPT Block Arrow facing right.
Page/introducti When you are ready, click on the arrow. Title placed to right of graphic
on centered horizontally.

Arrow will appear synced with

audio end.

ID: (1)Next Before we get started, let’s run through some basics on how to (1)PPT arrow pointing to Next button Screen will display navigation
Ben1_2_020 navigate this course. This is a self-paced course, but is organized in buttons that will be on each
(2)Previous an order that will prepare you for the drills, so please review each (2)PPT arrow pointing to Previous button screen throughout the course,
T: Full Screen slide before moving forward. but the buttons are non –
(3)Course Map functioning on this screen.
(3)PPT arrow pointing to Course Map
H1: Course Let’s start on the bottom right hand corner of your screen. Notice
Navigation (4)Replay screen the Next and Previous buttons. button Navigation buttons will be
Tutorial pointed to with an arrow
(5)Exit (1) Clicking the Next button moves you to the next slide. (4)PPT arrow pointing to Replay Screen (graphic) in synch with audio
(6)Let’s get started button as numbered.
(2)Clicking the Previous button returns you to the previous slide.
Note: The
navigation In the upper left hand corner of your screen, notice the Course Map, (5)PPT arrow pointing to Exit button. . Note: Synching of audio, text
buttons and Help, and Exit buttons. and/or graphic will be
placement indicated per numbered
(6) PPT block arrow pointing to the
described here (3) The Course Map button will display each screen title. Simply instructions throughout the
will appear on click on the title and you will be brought to that screen. For right course.
each screen example, if you need help navigating click on the screen title Course
throughout the Navigation Tutorial and you will be brought back to this screen. “Let’s Get Started” block
course, unless arrow will appear after tutoria
otherwise (4) The Replay screen button will replay any animation/audio. complete and move user to the
indicated. The next screen when clicked.
buttons (5)The Exit button will exit you from the course.
through the
(6)If you’re ready, click the “Let’s Get Started” arrow to start
course after
course.
this slide will
be active.

ID: Lesson Objective Upon completing this course, you will be able to differentiate Arrows pointing different directions.
Ben1_2_030 between a basic and a complex benefit
Participants will be https://pixabay.com/en/right-next-
able to differentiate note-road-sign-2620946/
 between a basic
T: Vertical
and a complex
text with
graphic benefit

Basic Benefit and

H1: Lesson
Objective Complex Benefit
(on arrow graphic)

ID: Why Categorize? So, why is it so important to categorize a benefit as basic or Woman giving questioning look (1)When Smart Art Job Aid is
Ben1_2_040 complex? clicked opens to pop-up
Categorizing a http://www.publicdomainpictures.net/vie
T: Vertical benefit guides our Determining if a benefit is basic or complex provides us with the w- Pop-up slide: picture of the
text with next step information we need to make a decision about our next step. We image.php?image=209294&picture=nurs job aid for Benefits 101. Step
graphic may either navigate the database to answer the benefit question or e pertaining to differentiating
• Navigate we may provide the member a warm transfer to a Member Services benefits highlighted in pink fo
the database representative to answer their question. emphasis.*slide does not
H1: Why
and answer contain any of the standard
categorize? (1) Click on the job aid on the bottom of your screen to see where
the (1)PPT Smart Art-Repeating bending navigation buttons,
member’s differentiating benefits fits in the overall job aid for communicating
process in a box
benefit benefits. (2)Clicking “X” returns to
question (2) X top right corner screen
Notice the highlighted area on the job aid. Differentiating benefits
• Provide a is one of the first steps and leads you to your next step.
warm (2)When you’re finished click the X in the upper right hand corner.
transfer to a
Member
Services
representati
ve to
answer the
member’s
question

Smart Art labeled

Job Aid with Step 1,
Step 2, Step 3, Step
4, Step 5
ID: What are basic One of the benefits of our case managers responding to basic Insurance?
Ben1_2_050 and complex questions from our members on their benefits is to provide
benefits? http://www.publicdomainpictures.net/vie
them with quick customer service. Of course, it’s important w-
T: Vertical
text with to recognize when the member’s request is more complicated image.php?image=192346&picture=insur
graphic and get them to member services so they get the most ance-background-with-dog
Basic Benefits: accurate information.
H1: Defining
basic and • Plan
information
2 PPT Circle Shape containing text
complex (1)Fortunately, we have limited access in our database. We
benefits can provide information that does not require any calculation (1)Basic benefits circle animates larger in
• Provider synch with narration
or detailed interpretation of coverage. They include basic
search
information about the plan, for example what the deductible (2)Complex benefits circle animates
Complex Benefits: of the plan is or if an incentive, like frequent fitness, is part of larger in synch with narration
their plan. Searching for providers that are within their
• Specific network is also considered basic. Providers listed in the
coverage database under a member’s chart are in network.
• Require
interpretati
(2)Complex benefits are for anything more detailed than those
on
identified as basic. This would be questions about specific
• Require coverage for a procedure, which can become very detailed
calculation and need interpretation, or questions about a denial. For
example, did I meet my deductible-how much more do I have
• Denials left for the year? There are many complex scenarios so it’s
usually easier to recognize a basic benefit. Anything else is
considered complex.

ID: Got It? Before we look at the action steps to take once we decide if a Thumbs up
Ben1_2_060 benefit is basic or complex, let’s practice what we’ve learned.
Let’s Practice! http://www.publicdomainpictures.net/v
Click to the next side to proceed. iew-
 image.php?image=199185&picture=s
T: Vertical
ilhouette-of-thumb-up-hand/
text with
graphic

H1:
Knowledge
Check
Introduction

ID: Knowledge Check Here are some sample benefit questions a member may ask. Chalkboard Drag and drop
Ben1_2_070
Basic Simply click on the question and drag it and place under the http://www.publicdomainpictures.net/v Answer in parenthesis next
T: Vertical correct category-either complex or benefit. iew- to text-take this out on
text with Complex image.php?image=37299&picture=sc screen and scramble
graphic • Who are my hool-chalkboard statements.
options for a Once you have placed each sample question under one of
Drag and Screen will have submit
dental provider? the categories, click submit
Drop button
(basic) Basic and Complex are in a created
H1: • I received a T-shape Once submitted:
Knowledge letter that a
claim for my If categorized all correctly:
Check-
Categorizing hearing aid was Pop-up (1) will appear and
denied.
user can move forward with
(complex)
next navigation button.
• What is my
plan’s co- If incorrect: pop-up (2) will
payment for a appear
preventive care
visit? (basic) OK button-once clicked
• I am going in goes to screen
for surgery and Ben_1_2_050
need to know
viewed next navigation button
coverage details
p you back to this slide to
about the
est.
procedure
(complex)
• Is there a
specific
pharmacy I must
fill my
prescriptions at
(basic)
• Does my plan
include a
 program for
tobacco
cessation?
(Basic)

Once submitted-
pop-up will appear
based upon
responses.
If correct: great job
on categorizing
those sample
questions! You’re
ready to move
forward” Click the
next button to
continue.
.
If incorrect: Nice
try, but at least one
of those is
categorized
incorrectly. Before
we try again, let’s
go back and
review the benefit
definitions again.
Click ok to go to
the definitions.
Once you’ve
reviewed them
click the next
navigation button
and you will be
returned to this
screen to re-try the
knowledge check

ID: I’ve identified the So, what’s our next step? Man pointing at a choice Basic and Complex boxes
Ben1_2_080 benefit, now what? are roll overs
T: Vertical Now that we are able to differentiate between a basic and https://www.google.com/search?q=m
text with complex benefit, rollover each box to see what your next an+pointing&safe=strict&hl=en&tbm
graphic Basic (rollover) should be. =isch&source=lnt&tbs=sur:f&sa=X&
Navigate the ved=0ahUKEwjtgeisg5_ZAhUHTKw
H1: Actions
steps after database and KHQsRAW8QpwUIHg&biw=1366&
benefit respond to their bih=672&dpr=1#imgrc=qzTw9MQn2
identified. question. sFEJM:

Complex (rollover)
Provide the 2 round rectangles
member with a
warm transfer to a
Member Services
representative so
they can get their
question answered.

Knowledge Check Clicking on yes or no

ID: We will be looking more at the best practice of a warm Woman on headset phone
response submits the
Ben1_2_090 transfer and specific navigation of our database in future
I thought I met my http://www.publicdomainpictures.net/v answer. Pop ups will
deductible for the lessons, so don’t worry. For now we just want to make sure appear based on if answer
T: iew-
Dichotomous year, are there we are confident in differentiating basic and complex so we image.php?image=15334&picture=w correct or incorrect.
question claims that are still know what our next step is. oman-with-phone-headset
waiting to be paid
H1: that could be Let’s practice. This is a Case Manager, Maria. Read the
Knowledge causing my question that member is asking and Maria’s response. Decide
Check-Case deductible to not if you agree with Maria’s response by clicking Yes or No. Quote bubble with member question
Example 1 be up to date?
(member question) Quote bubble with Maria’s response
next to her picture.
To best
answer your
question, I’d
like to get a
Member
Services
representative
on the line
with us, so
they can
assist in
answering
that, can I
place you on
hold while I
reach them?
(Maria’s
response)

Do you agree with

how Maria handled
this question?

Yes (correct)

No (incorrect)

Based upon
correct or
incorrect, pop up
response.
• If yes answer
Yes! This was
tricky, but
although it is
about
deductibles, it is
complex. This
may take some
calculating and
review of claims
coming in which
would best be
addressed by
Member
Services.

• If no answer:

This is a tricky
question. The
member is
asking about
deductibles,
they are
 asking specific
about how
much is left
and claims
versus a
straight
amount from
the benefit
plan.
Is there a Clicking on yes or no
ID: Let’s try another one. Woman on headset phone
frequent fitness response submits the
Ben1_2_100
http://www.publicdomainpictures.net/v answer. Pop ups will
incentive as appear based on if answer
T: iew-
part of my correct or incorrect.
Dichotomuos image.php?image=15334&picture=w
question plan? (member oman-with-phone-headset
question)
H1:
Knowledge I can assist you
Check-Case Quote bubble with member question
Example 2 with that
question, if you Quote bubble with Maria’s response
can give me a next to her picture.
second, I’ll go
into our database
and look at your
information.(Mari
a’s response)

Do you agree with

how Maria handled
this question?

Yes (correct)

No (incorrect)

Based upon
correct or
incorrect, pop up
response.
• If yes answer
 Yes! This is a
basic benefit
question about
whether an
insurance
product has this
incentive
• If no answer:
Hmmm, let’s
check this again.
This is a
question about
an incentive a
health plan
would or would
not have and
we should be
able to access
that for the
member.
My doctor Clicking on yes or no
ID: Keep going, let’s look at another case. Woman on headset phone
Ben1_2_110 prescribed me response submits the
http://www.publicdomainpictures.net/v answer. Pop up’s will
a medication appear based on if answer
T: iew-
and the correct or incorrect.
Dichotomous image.php?image=15334&picture=w
question pharmacy said oman-with-phone-headset
that this was
H1: not covered by
Knowledge my insurance,
Check: Case Quote bubble with member question
Example 3 can you help
me with that? Quote bubble with Maria’s response
(member next to her picture
question)

I can assist you

with that
question, if you
can give me a
second, I’ll go
into our database
and look at your
information.
(Maria’s
response)
Do you agree with
how Maria handled
this question?

Yes (incorrect)

No (correct)

Based upon
correct or
incorrect, pop up
response.

If No: “Good job!

This is a potential
denial or non-
coverage issue, so
it is considered
complex and Maria
should have
provided a warm
transfer to Member
Services for
assistance
If Yes:
“Medications can
be tough, but since
this a potential
non-coverage or
denial, it is
considered
complex and Maria
should have
provided a warm
transfer to Member
Services for
assistance
 Could you help me Clicking on yes or no
ID: Here’s our last one Woman on headset phone
find a doctor that is response submits the
Ben1_2_120
in my network? http://www.publicdomainpictures.net/v answer. Pop up’s will
T: (member question) iew- appear based on if answer
Dichotomous image.php?image=15334&picture=w correct or incorrect.
question I can assist you oman-with-phone-headset
with that
H1: question, if you
Knowledge
Check-Case can give me a Quote bubble with member question
Example 4 second, I’ll go
into our database Quote bubble with Maria’s response
next to her picture
and look at your
information.
(Maria’s
response)

Do you agree with

how Maria handled
this question?

Yes (correct)

No (incorrect)
Based upon
correct or
incorrect, pop up
response.

If answered yes:
Yes! This is a
basic question
about finding an in
network provider
If answered no:
“let’s check this
again. This is
looking for an in-
network provider
and we have
access in our
database for this
 so could help our
member.

ID: Congratulations!!! Congratulations, you have successfully completed the lesson No navigation buttons on
Ben1_2_130 on differentiating benefits, which is a vital part of our job aid. this screen. Just end course
Credits button which exits.
T: Vertical
You are now be prepared to identify a basic or complex
text with
graphic benefit which is important as it guides our next step of
answering the benefit question yourself or providing a warm
H1: Review transfer to a Member Services representative.
and credits