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A new Humana member is interested in knowing more information about Humana's Rx Mail Order Pharmacy.
what should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Rx Mail Order
Member is calling because she wanted to know if she already met her yearly Part D deductibles.
What should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Accums
Member wanted to order an OTC items and you're the one who received the call.
what should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx Mail Order OTC
INTENT: Ordered
Member called yesterday and talked with a Humana advocate. During the conversation they had, she updated her demographic information (Address) since the member just moved to a new location (New address still in service area of the plan). Now you received the call from the same member and member wanted to make sure that her address was updated as well in her Mail Order Account. what should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx Mail Order Member Profile
INTENT: Add/Update Demographics
Member has prescription drug plan since 2015. Member is already aware of the requirements on all of her medications to be covered. Member is requesting for assistance in initiating an authorization for one of her medications. what should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Prior Authorization
Member is calling because she wanted to know ow much does she need to pay for a new medication that was prescribed by her doctor. What should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Benefits and Copayment
Member moved to a new address but within the same state. Member talked to Humana advocate before moving and address was updated already on the system and member was told that she don't need to change plan because the new address is still within the service area of the member's current plan. Now the member wanted to check for an in-network pharmacy in the area. What should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Pharmacy Finder
Member calling in asking for assistance with her medication. Member stated that she went to the pharmacy yesterday to refill for her prescription, but that pharmacy was saying that she needs to pay for the medication because Humana is not going to pay for it. What should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Claims
Member went to a cruise ship vacation and while on the ship, her medication supply ran out. Member was forced to buy at the On-Board Pharmacy and paid from her own pocket. Now, the member is calling in to check if she can send the details of the purchase so that she can be reimbursed? What should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Direct Member Reimbursement
As an advocate, we have the power to help members that have a concern with their medication especially if they will be on a vacation or they were affected by a disaster. if these will be the concerns that we need to assist, what should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Non-Clinical Override
You received a call from a member that was recently enrolled and approved to have LIS (Low Income Subsidy). Now the member wanted to know more information how LIS is helping them towards their medication. What should be the Classification and Intent we are going to use in order for us to assist the member?
CLASSIFICATION: Rx
INTENT: Discount Program