Humana General
Mentor Docs
PPI
Quality
CAS Screens
100

Humana google

What is Mentor

100

Used to find Cru routing instructions

What is Pcc Job Aid

100

Needed before payment information can be provided

What are two pervious payments

100

This needed before providing policy information

What is correct authentication?

100

Displays the coordination of benefits (COB) information for each individual under the member ID.

What is the CRI Screen

200

PPO Policies

What is plans with In and Out of network benefits

200

Used to confirm Authentication Process

What is HIPAA Overview PCC

200

can be provided to the caller once the check number and details are given

What is all information requested?

200

This amount of information is needed before a call is considered authenticated

What is 3 pieces of information

200

Displays the history of all claims on an individual member or specific claim information if the claim ID is entered.

What is the MHI Screen

300

HMO Plans

What is plans that have only In network benefits

300

Used to assist providers with amking demographic changes

What is Provider Issues PCC

300

Time period before a reissuance of check can be requested

What is 30 calendar days

300
Can be used if member ID is not correct

What are Zip code, group name, group number, product type

300

used to display member/dependent information from the Claims Administration System (CAS) Eligibility File.

What is the MRI Screen

400

ASO

What is Administrative services only

400

Used to locate updates and changes

What is CRM Hot Topics

400

This is needed before an affidavit can be requested

What is Copy of cashed check

400

Must be verified if different from initially provided information before claims details can be provided

What is rendering provider information

400

used to display member/dependent information from the Claims Administration System (CAS) Eligibility File.

What is the MDI Screen

500

COB

What is coordination of benefits

500

Used to determine C & I

What is CRM Service Classification and Intent

500

Service center, department, Topic used when sending copy of check request

What is PPI, Stop Payment, Check copy request

500

Must be provided when transferring a call to another department

What is name and contact number for that department

500

Needed for the control lines on the MHI screen

What is MHI, Member ID,,First Name,Relationship,Claim Number

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