Misc
you press in DIG to send and incomplete letter
What is the Grp INC LTR button
The home screen
What is EPER?
A federal agency within the United States Department of Health and Human Services (HHS) that administers the Medicare program and works in partnership with state governments to administer Medicaid.
What is CMS
When a member’s enrollment did not cleanly flow through Humana’s Automated Enrollment system
What is a pend?
This screen displays all the member’s Termed and Active coverage in CI
What is PESL
These systems allow you to view enrollment applications
What is SPIDAR/FASTAPP
This screen houses the demographic information
What is EPDM?
CMS refers to their customers (i.e. members) as __________ .
What are beneficiaries?
This is where CMS contracts with a single provider (Humana) to provide retroactive and Point of Sale (POS) prescription drug coverage for certain Low Income Subsidy (LIS) eligibles.
What is Limited Income Newly Eligible Transition?
This is the home screen
What is PAPI
Medicare's annual Open Enrollment Period (October 15–December 7) when beneficiaries can join a Medicare Advantage or Medicare Prescription Drug plan.
What is Open/Annual enrollment period
Displays pended PCP info
What is EPPC?
A supplemental plan to pay a portion of the cost of services not covered by Original Medicare coverage.
What is a Medicare Supplement?
This is additional coverage above the scope of their MA and MAPD which may include Dental, Vision, Fitness, and others depending on the member’s plan options.
What is an Optional Supplemental Benefit
You use this screen to create a task
What is PATR
A three-digit code used to explain the specific reason for a Special Election Period.
What is an SEP Reason Code
What is EPCR?
This screen is used to real-time once pend errors are resolved
A type of Medicare managed care plan where a group of doctors, hospitals, and other network providers agree to provide care for a set amount of money every month. You usually must get your care from the providers in the network.
What is a Health Maintenance Organization?
Persons who are entitled to Medicare (Part A and/or Part B) and who are also eligible for Medicaid.
What is Dual Eligible?
This screen houses the beneficiary's demographic information
What is PEDM
Members enrolling using AEP will receive the following effective date
What is 1/1/26
View and correct pended benefit record
What is EPBR?
This Go/Meg document do you access to obtain CRM Notes for each scenario
What is the Group Medicare Classification, Intent and Notes Guide
This screen displays all the member’s Termed and Active coverage in
What is PAAL
This screen will allow you to search the member by name and DOB
What is PESL