Black Pink
This tool allows the member to safely add or edit credit card numbers in their own account through IVR.
What is Secure Pay
Payment method which contains preprinted payment stubs that include the coverage period, due date and the total premium due.
What is Coupon Book
A unique type of demographic that only SSA office can make this change.
What is Date of Death
A set dollar amount that Medicare members are responsible for paying in exchange for insurance protection.
What is premium
It can take up to ________ days for members to see an increase or decrease in their Social Security check when switching payment method to SSA Deduction.
What is 120
Primary tool used in checking and quoting for the benefits of a member.
What is Debut
It is a tool that allows you to view an electronic copy of a member's ID card.
What is ID Card Center
Policy provision requiring a member's doctor to obtain approval ahead of time before Humana will cover the costs of a procedure, test, treatment, or medical device.
What is Pre-Authorization
These are concerns regarding the quality of care received, the attitude of the provider, or lack of access to requested or needed medical services.
What is QAA Complaints
Amount the member must pay out of their own pocket before Humana will pay any expenses.
What is Deductible
A type of authorization that allows a member to be referred to a specialist.
What is Referral
A member who has contacted Humana within the last 14 days about the same issue without any resolution.
What is Repeat Caller
A medical care delivered in the patient’s home, if you are homebound while recovering from an illness, surgery or injury or have a chronic medical condition.
What is Home Health Care
Specific attributes that identify a member's identity.
What is Demographics
A doctor specializing in family practice or general internal medicine who coordinates and manages a patient's overall medical care.
What is Primary Care Physician (PCP)
The online system used to process one-time payments.
What is e-billing system
The amount of money the insurance company agrees to pay to a healthcare provider for specific healthcare services a member receives when they visit the doctor or hospital.
What is benefits
A monthly, personal health finance and benefits statement that includes a member's medical and/ or prescription drug claim information.
What is Smart Summary
Services a member uses to help stay healthy, prevent illness, or detect serious illness in the early stages when it may be easier to cure.
What is Preventive Services
Used to order paper copies of benefit information such as handbooks and welcome kits.
What is OMS - Order Management System
Member expresses dissatisfaction with any aspect of their plan or their experience.
What is Grievance
The main tool that advocates used in locating a provider or a doctor.
What is Physician Finder
Humana issues bills around 20th of each month. Premiums are due on the __________________.
What is 1st of the month
A cost saving measure that prevents members covered under multiple insurance plans from receiving duplicate benefits.
What is Coordination of Benefits (COB)