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100

Member calls to inquire about their SmartSummary. What is the correct C/I?

Communication:SmartSummary

100

Member calls to make a payment. What is the correct C/I?

Billing:Make Payment

100

Member calls to update their address because they moved. What is the correct C/I?

Demographics:Change

100

Member calls looking for a cardiologist in network. What is the correct C/I?

Provider:Locate

100

Member calls to request Provider Directory. What is the correct C/I?

Fulfillment:Benefit Information

200

Member calls because they want to receive their communications in Spanish. What is the correct C/I?

Communication:Member Preferences

200

Member calls to ask if his premium is up to date. What is the correct C/I?

Billing:Account Balance Inquiry

200

Member calls to verify we have a correct phone number on file. (It is correct)

Demogrphics:No Change

200

Member calling to change their PCP. What is the correct C/I?

PCP Change:PCP Change Made

200

Member calls to verify if their plan is active. What is the correct C/I?

Eligibility:Verification

300

Member calls because they do not understand a letter they received. What is the correct C/I?

Communication:Got a Letter/Call

300

Member calls to request new Coupon Book. What is the correct C/I?

Billing:Payment Changes

300

Member changed their name and needs it corrected. What is the correct C/I?

Demographics:Change

300

Member calls to verify whether their doctor is in network. What is the correct C/I?

Provider:Locate

300

Member calls to request a new ID card. What is the correct C/I?

Fulfillment:ID Card/Access Card Request

400

Member calls because they want to be removed from an automated (VAT) list. What is the correct C/I?

Communication:Got a Letter/Call

400

Member calls because they want to add their Credit Card as a Payment method. What is the correct C/I?

Billing:Pament Changes

400

Caller informing us that member is deceased. What is the correct C/I?

Demographics:Report Date of Death

400

Member calls to change their PCP but we are not able to make the change. What is the correct C/I?

PCP Change:PCP Not Changed

400

Member calls to request Consent Form. What is the correct C/I?

Fulfillment: Letter/Form Request 

500

Member calls because they want to 'go paperless'. What is the correct C/I?

Communication:Member Preferences

500

Member calls because they accidentally overpaid for their premium and they want their money back. What is the correct C/I?

Billing:Premium Refund

500

Member calls because they forgot their password for MyHumana. What is the correct C/I?

Web/Mobile:User ID/Password

500

Member calling to ask for their PCP's number. What is the correct C/I?

Provider:PCP/PCD

500

Member calls to ask why they have not received their ID card for next year. What is the correct C/I?

Fulfillment:ID Card Status

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