Humana Systems
Locate explanation of remittance (EOR) for all claim payment types
What is ARI
The screen we use access customer information
what is Customer Interface (CI)
The number of Chiropractic visits allowed in a year
What is 26 per year
We look forward to this every other Friday
What is payday
Next pay 6/21
Locate letters sent to providers from teams that don't work in MedHok (except Provider Correspondence and Grievances and Appeals)
What is EMME
This is also a Spanish word for Daddy
What is PAPI
this will bring up the member package inquiry, Shows the current and previous plans
These items are not covered under DME (Durable Medical Equipment) but are covered under Home Health
What is home health
We do this to make sure we get paid
Submit your time!!
Remember to fill out your time sheet daily,
Workday will send automatic emails reminding you to submit time by Monday at noon, Brian typically approves over the weekend
Locate medical records sent to Humana
What is MRM (Medical Record Management)
The document that walks you through the process of member eligibility
What is Member Eligibility ccc Provider
What is telehealth?
What is going to be your first PAID Holiday
What is July 4th
Remember per our contract we are taking calls, but it is done on a volunteer basis
Are we off that day???
View status of Grievances and Appeals submitted by providers and members
Grievance and Appeal status (CRM link)
G&A (abbreviated)
The Session number we use for KYMCD
what is 58
If the member wants to quit one of Kentucky's major crops they want to do this
What is tobacco cessation
This is the name of the App that can earn me WOW bucks, and tracks various things
What is Virgin Pulse
The 4 systems we have covered thus far
What is CRM CAS PAAG PFP (Dig we downloaded but have not went into detail
This allows me to jump from screen to screen.
what is a command
PAPI PESL PMAX
The member has these benefits, but we do not process the claims
What is vision and dental
Avesis will process the claims