Thor
This page/app consists of links of different systems/tools a Humana advocate use, and can be found on top of the HI! (Humana Intranet) page.
What is HSS- Humana Self Service
Manages all internal email messages and calendar events.
What is Humana Outlook
The system primarily used to answer, research, and document calls
What is CRM- Customer Relationship Management
2 ways on how to lock your computer each time you leave to ensure privacy and security.
What is Pressing Ctrl+Alt+Delete then hit Lock computer, or Window tab+L key
This website/unsecure site we offer and promote to members to utilize self-service.
What is Humana.com
The federal privacy law that protects our members PHI.
What is HIPAA - Health Insurance Portability and Accountability Act
Document index should a Humana Medicare Advocate opens in Mentor before starting their day.
What is Medicare Advantage Prescription Drug Doument Index
Any information that identifies an individual and must be kept private.
What is PHI - Protected Health Information
Fields under this are populated based on information entered by the caller in the IVR system.
What is Interaction Log
This is the secure portal of Humana.com and requires a successful sign-in before accessing information.
What is MyHumana
Government-sponsored healthcare for seniors and disabled.
What is Medicare
Call Flow which consists of 8 steps to make sure that a member will not be a repeat caller.
What is First Call Resolution
Alert indicator when we need to verify member's demographics.
What is Contact Handling Alert
Provides protection from financial loss.
What is Insurance
Part of original Medicare includes Original Medicare (Parts A & B) plus extra vision, dental, or drug benefits offered by private insurance carriers.
What is Part C
Yearly timeframe in which Medicare-eligible individual can enroll in a new plan and disenroll from their current plan. It runs from October 15 to December 7.
What is AEP (Annual Enrollment Period)
3 authenticating elements in verifying member's identity.
What is member's identification number plus any of the following: Date of Birth, Zip Code, Phone Number or Address, Group Name, Group Number or Product Type
This word displays when the member did not successfully enter the member's identifiers in the IVR.
What is unauthenticated
Humana's 4 guiding principles to ensure perfect experience for our members.
What is Know Me, Show Me You Care, Make it Easy and Help Me
This is the ability to understand or feel what another person is experiencing.
What is empathy
The federal agency within the U.S Department of Health and Human Services working in partnership with state governments establishes rules that private insurance companies, like Humana, must follow.
What is CMS – Center for medicare & Medicaid Services
An internal search engine and repository for all call handling procedures.
What is Mentor
It is a tool used while working in CRM to help document case notes and comments quickly.
What is Quick Start+
This button is selected when members call about themselves.
What is Interacting With and About
Member permission can be communicated in 3 ways.
What is Consent Form, Power of Attorney or Excutor of Estate designation or Verbal Consent