General
The five principles of Humana.
Know Me, Show me you care, make it easy, help me
This is used to verify identity.
Member ID number, DOB, and zip code.
This screen shows demographics.
PEDM
This screen shows a list of all policies.
What is PAAL?
This system shows only INN providers.
What is Physician Finder Plus?
The steps in the call flow?
8
This protects PHI from being disclosed to unauthorized personnel.
This screen creates a task.
PATR
This screen shows PBP and contract number.
What is IPBD?
This doctor specialize in the brain.
What is a neurologist?
The 4 categories in ECHO are directly affected by the CCS.
Agent Satisfaction, Agent Courtesy, Agent Knowledge, Issue Resolution.
Health Insurance Portability and Accountability Act.
How often demographics must be verified.
What is every 90 days?
Locating a member by name.
What is PESL?
Member time frame to access an email.
What is 72 hours?
This is known as NPS.
Net Promoter Score
Authentication verifies this of the caller.
Identity and authority (consent)
These policies allow the member to be OSA for 12 months.
PDP and PPO
This screen is used for hospital admissions.
What is PRI?
These are given for every provider located.
What are benefits and authorization/referral.
The 8 steps of the call flow.
Greet, Empathy, Understand, Resolve, Next Steps, Additional Assistance, Recap, Close
PHI stands for this.
Protected/Personal Health Information
Member must be advised of these things when moving permanently.
Contact SSA and speak to mail order.
This screen shows detailed referral information.
What is RFI?
This system shows all providers?
What is PAAG?