This is the Line of business for Medicaid
(Hint: its a #)
What is 93
Mary is calling from VCU medical admin dept, for the member Gary Clark. This is what you would put in the "Name" field of the Interaction log
What is Mary?
This is the info used to authenticate a provider in order for them to receive a member's info.
What is NPI/TIN & Provider/Facility Name
This is the benefit you quote if a provider wants benefits for treating a rash on a patient's leg for a member.
What is physician Services?
Mary is calling from VCU medical admin dept, for the member Gary Clark. This is what you would put in the "Interacting About" field of the Interaction log
Members AND providers can both use this system to locate a provider in the member's network.
What is Find Care/Humana.com?
True or False
A provider calls in about several member, but you only need to authenticate the first member
What is False?
Mary is calling from VCU medical admin dept, for the member Gary Clark. This is what you would put in the "Interacting With" field of the Interaction log
What is VCU Medical?
When it comes to COB, Medicaid is always ____ to other insurers.
What is secondary?
This a vital part of building rapport with members.
What is Active listening?
These are the required parts of the standard greeting
What is "Thank you for Calling Humana" & your name
This is what you must do before you place a caller on hold.
What is ask for permission, wait for a response & Check back every 2 mins
What does D-SNP stand for?
Dual eligible special needs plan
This is needed to give accurate Benefit info.
This is who providers contact to receive their 1099 tax form.
What is Accounts Payable (AP)?