HIPAA
HIPAA stands for
What is Insurance Portability & Accountability Act
1/1-3/31
What is OEP
Where would I look for all active and termed for a mbr
What is PAAL
Requesting policy to come to a end after call by date
what is disenrollment
requesting policy to come to an end by call by date
What is Cancellation
What does HIPAA ensure ?
What is Protects PHI
10/15-12/7
What is AEP
advising member they will term for 107
what is Eligibility verification
How do we determine if the member is able to disenroll from a policy when we are outside of AEP?
what is Go through the SEP questions with the member to check a valid SEP to disenroll.
What election period does a member need to cancel a plan
what is no election needed
Member Name, Member ID, DOB, Complete address, Complete SSN, Medicare ID.
What is the items used to authenticate Member's account
3 months before, during birth month, and 3 months after
What is IEP
what screen do you use manually to search a member using the member ID ?
what is UMID
What are the different methods a member can submit disenrollment forms?
What is ?
1. Complete and submit the forms online via Humana.com
2. Write their own request.
3.Print the disenrollment forms online.
4. Receive the disenrollment form by mail.
Once you have verified the member is in CRM, the policy is active in CI, where must you also check to make sure the policy is active?
what is MARX
This form is still valid if the Member is still alive and no longer an active Member.
What is a POA?
I can make as many changes as I want to my plan during this time period.
What is AEP?
when a member wants to disenroll a policy that you do not handle ?
what is disenrollment out of scope
the urgent fax number
what is 1-866-449-0316
When processing a cancellation of cancellation request and the TS is workable, what do you update the TS to?
what is 04
this type of POA can not Receive PHI
what is POA type U
what election period does a member need to disenroll from a FSB dental/vison plan
what is no SEP needed
use this screen to see contract and PBP
what is IPBD
what Kinda of dental plan has the name Dental Value (HI215)
which is FSB dental
If a member calls in and says "I never enrolled into this Humana plan" and its PAST the effective date. What should you do?
What is File a Section A