Overview
These are the different kind of demographics that can be changed
Name, Address, Telephone Number, Email address, Medicare ID, Date of Death, Date of birth and Gender.
This is the call procedure for verifying demographics
Verify Demographics for Medicare and Medicaid Members
What is one way to determine if the member is out of service area
Step 1 has you do this first
Verify demographics
In CRM, the address is updated with this template
Update Plan Demographic template
This is the mentor you would use to update a phone number or email
Phone Number and Email Address Changes
Per the AVF Letter actions, even if the address on file is correct, this must be completed for the OSA team to investigate.
Update Plan Demographic
You would go to this step if the address didn't update successfully
Step 17
Members can't use this as a residential address unless they confirm they are homeless or reside in a shelter.
PO Box
This is the primary procedure for Group Medicare advocates
Group Medicare Demographic Changes
Under this program members can travel to specified areas for up to 12 months based on plan level benefits
Traveler's Program
According to this step, if Humana can't complete the change you would advise the caller how they can have their demographics updated by referring the member to Group/Third-Party Administrator.
Step 5
Only the following individuals can verify address or request changes:
Member, POA/EOE, Agent of Record/Career Agent/Writing Agent
This is the call procedure if you were looking to update the Date of Birth for a member
Name, Date of Birth, or Gender Changes
This alerts a member that their address may have changed. It serves as a notification that their address might be outdated based on Medicare's records or the plan's own data.
Address Verification Form (AVF)
This is the step that tells us to complete the updates in the Update Plan Demographics template.
Step 11
If the Update Plan Demographics template change is successful and not a future dated change, it will be updated in CI in real time but could take CRM this long to display
24-48 hours
Document in case comments: First/Last Name, Home Phone and work Phone. Transfer the case to Louisville>RSO Enrollment>Demographics and Housing Verification Return.
PPO and PDP members can temporarily out-of-service area for this long
12 months
When GMAIRC is unavailable you would refer to this to determine if Humana can make the address update.
Group Medicare Customer Number Grid