Intro to DEO
To assist potentially eligible individuals with applying for the Medicare Savings Program, Low Income Subsidy and screen for Food Insecurity and offer local food bank information
What are the functions of the DEO phone team?
To drive inbound call volume from Humana’s members
What is one of the main goals of the DEO Member Outreach efforts?
The DEO department separates States into two distinct categories - ___________ States and ____________ States
A member's primary WHAT never counts against them as an asset?
What is residence?
Address Verification occurs during this part of the call process
DEO Call Closing Steps
An applicant can qualify for different levels of LIS depending on what?
What is on their income/asset totals and household size.
These should be included in DUET Call Notes
What is:
If the member appears to potentially qualify or DQs (and the potential MSP level or DQ reason),
All income and assets sources/values
If there is information the member needs to fill in themselves once they receive their application via mail or e-mail
The Phone Team, The Application Checking Team (ACT), The Quality Assurance (Q/A) Team, The DEO Support Team, The DEMail Team
What are the teams in DEO?
Individuals paying the Medicare Part B premium, Individuals with income and asset totals that do not exceed their state’s limits
Who is eligible for the Medicare Savings Program?
The Vendor Humana uses to assist in the MSP process is called
Who is Change Healthcare?
If an applicant owns more than one vehicle, this vehicle counts against them as an asset
What is the lowest valued?
Before a MSP application begins, Before PHI is discussed, this should take place
Applicants will receive a determination letter in the mail from the SSA
What is how applicants will be notified if they have qualified for Low Income Subsidy?
These systems reflect a members’ designated Power of Attorney (if they have one)?
What are CI and CRM?
Reviews applications completed by the Phone Team, creates missing document checklists, reviews applications for potential errors, and assists with submitting applications to the States for processing
What is the Applications Checking Team (ACT)?
45-90 days (up to 3 months)
What is how long might it take the State to review and determine eligibility, once a member’s application is submitted?
The Full application and details and Document Check list are all Housed in
What is DUET?
The applicant/spouse have qualifying pre-designated burial funds or prepaid burial arrangements that fall within the parameters outlined in the State Guidelines
What is when burial exclusions might apply?
These call sources are already authenticated
What are VAT calls and warm transfers?
LIS income limits are located here
What is the DEO Sharepoint Site?
When a DEO call representative adds notes to CRM
What is after an application for MSP/LIS has been completed?
Audits the Phone Team’s inbound/outbound calls and mail correspondence sent by the Application Checking Team
What is the Quality Assurance (QA) team?
Once enrolled in a MSP, the member’s state may require periodic ____________ to confirm ongoing eligibility.
What is recertification?
These states Require applicants to submit supporting documentation with their MSP application and have the ability to confirm income and asset information electronically once an application is received
What are states that follow the Traditional Process?
Wages received from working a full or part time job
What is Earned Income?
According to the Initial Call Handling document, you should you THIS next if you cannot find a DUET page for the member?
What is nothing, a DUET page will be created later
True or False, you are able to complete an LIS application for a member and spouse when one is not present.
What is false.
This is how should you proceed with a call in the event EASE is down but the member needs a new Eligibility Interview.
What is enter all eligibility information on the Eligibility Interview Spreadsheet and reference the state’s income/asset limits to determine if a member appears to potentially qualify?
A brief review of a member’s income and assets to determine if they are potentially eligible for a MSP
What is the Eligibility Interview?
After an application is completed in EASE, it is sent to the member via mail or e-mail. The member is responsible for ______
What is signing the application, gathering any required documents, and returning the application to Humana?
These states have the ability to confirm income and asset information electronically once an application is received
What are states that follow the Self-Declaration process?
The cash amount a person can receive from cashing-in or borrowing from the policy
What is cash surrender value?
True or False, a UMID is required from a member who is contacted via VAT
What is False?
True or False: When an applicant DQs for MSP, they are automatically disqualified from LIS
What is false
These are the two systems which reflect the member’s plan information, effective dates, and premium payment information.
What is CRM and CI?