Know Me
This is the tool that advocate use for premium billing.
What is eBilling?
This is private health information.
What is PHI
This is Medicaid
What is MCD?
This should be verified every 90 days and it includes Address, Phone # and email address.
What is Demographics?
This is critical when speaking with callers about death
What is empathy?
This is what we called EOC?
What is evidence of coverage?
This is the personal identifiers that we do not ask to members.
What is SSN
Used when a change is made to contact or critical demographics for any reason including address, email, phone and more.
What is demographics/Change?
This is the tool we used for CMS corroboration.
What is Wipro?
True or False. We use MARx
False
This is what we called POA. Callers are calling in behalf of the member and and they are authorized to access the account.
What is Power of Attorney
Members are responsible for paying a set dollar amount in exchange for insurance protection.
What is premium?
This is one of the payment method Humana has and this is called transferring funds electronically to pay premium.
What is ACH?
Members can request this letter to confirm how much they owe Humana every month.
What is premium verification letter?
Member needs to wait days to receive the mailed letter that Humana sends
What is 7- 14 days?
True or False Provider can change address for the member.
What is true?
This is the members due date.
What is the first day of the month?
Members can choose the SSA deduction option as long as their premium does not exceed a dollar amount.
What is $300?
Showing all medications covered under Humana's drug list.
What is Full Prescription Drug guide?
This is used to order paper copies of benefit information handbooks and welcome kits.
What is OMS?
These are the specific attributes that identify a members' identity
What is demographic
Containing a list of providers.
What is provider directory?
This is the mentor document for a complete list of the items like handbook or welcom kits.
What is OMS and OES Code index?
This is the classification and intent for requesting a EOC or Provider or prescription list.
What is Fulfillment and Benefit information?
A caller is asking OTC form. This is the classification and intent we used for this type of calls.
What is Fulfillment and letter/form request?