When should a member call to cancel their policy?
Before the effective date of the plan OR before the call by date
What is the C/I for a Disenrollment call?
Disenrollment:Info Given
CI Screen to send an ID card
PAID
Main Mentor doc used for DE
Disenrollment and Cancellation Medicare Inbound Calls Team Overview
What are the two types of allowances a member can have on their spending account card?
OTC and Healthy options
When should I create the subtype for a cancellation?
After you locate the member in CRM
Which type of plan are not able to use the CHAMPVA as a SEP?
MA (Medicare Advantage plan)
In which CI screen can I find the Transmit Stats Code?
PAIG
Use Workable Transmit Status Code for Calls to determine if code 51 is workable or non-workable
Non-Workable
What are the 3 steps in the VOB cycle?
Quote the benefit, verify the provider, verify is ana authorization is needed
Where should I send the case if the member states that they wanted to be reinstated back onto their previous Humana coverage?
What information needs to be included in a written request?
"I wish to disenroll from my plan type for de/date due to having election period."
Signature
Humana ID
CI screen used to determine the level and eligibility of medicaid
MEVH
Mentor Document used for Incarceration?
Incarcerated or Unlawfully Present Member
What is out closing for transfers?
It's been a pleasure locating your account. Now I will connect you to (department you are transferring to). Thank you for calling Humana. We are always here to help.