CSNP
This is the name of the form that is needed to qualify for a CSNP plan.
What is the Verification of Chronic Condition form (VCC)
What are the 6 categories of VOC?
NPS, Agent Helpful, Agent Ease, Agent Care, Process Ease, Issue Resolution
What is the name of the Mentor document that is updated with important topics?
Medicare Hot Topics
True or False: Once the deductible is met the member will have a $0 responsibility for all covered services.
False
When and where was Humana founded?
1961 in Louisville, KY
True or False: We are now able to call the provider's office to verify and complete the VCC form on the member's behalf.
True
Please and Thank You are examples of these.
What are soft skills
What is the name of the Mentor document we follow if a member calls in about a denied pharmacy claim?
Actions for RxNova Error Codes
What does EX Code 08Z mean?
Primary care physician (PCP) referral not on file.
What is the top selling album of all time?
Michael Jackson's Thriller with 70 million copies sold worldwide
The member's VCC Status is EC, what does that mean?
Enrollment Complete, the member is eligible for the CSNP plan.
What is the name of the system used to check VOC scores?
In Moment
A member wants to make payment arrangements for a past due premium balance and they are eligible to, where would we transfer our case?
A pharmacy claim processes with Authorization number 2100066. What does this tell you?
It's a transition supply
How many feet are in a mile?
5,280 feet
What are the two End Reason Codes that may show if a member's enrollment into a CSNP was denied?
117 (Incomplete - MBR Not Qual for SNP)
118 (SNP Not Validated)
A member gives you a rating of 4 for Agent Care, what does that count as?
0%
What Mentor document do you follow when the CRM PCP Change Template isn't successful?
Resolve PCP Change Errors in CI
What is a POT code?
Place of treatment (POT) codes are alpha or numeric codes that indicate where a service was performed.
If you are enrolled in the company medical plan, you AND your covered spouse/partner are responsible for completing a biometric screening and the Health Check Assessment by what date to avoid additional costs in 2027.
September 30, 2026
What classification and intent do we use when contacting the provider to complete a verbal VCC for the member?
What is the difference between sympathy and empathy?
Sympathy is a concern for someone who is experiencing something difficult or painful. Empathy involves actively sharing in the person's emotional experience.
Can a POA Type O change a member's PCP? What Mentor document is this found in?
No. POA Types and Allowed Actions
A member has extra help level 2 (code 1002), what is their copay for a generic or preferred drug?
$1.60 (unless the plan benefit is less)
What is the chemical compound for water?
H2O