Billing
How long can it take for CMS to switch a member to or from the SSA deduction payment?
120 days
Who is authorized to request demographic changes?
Authorized Power Of Attorney
What are the two tools used by advocates to assist members with locating a participating provider?
PAAG and Find a doctor
What tool is used for new or additional ID card requests?
ID Card Management
"I need knee surgery, does my plan cover that?"
Benefits :: Verification
Members can choose the SSA deduction option as long as their premium does not exceed what dollar amount?
$300
What type of demographic information is never asked of callers?
Social Security Number
Who is eligible for Medicare?
65 years and older
End-Stage of Renal Disease
What are the types of notification a Humana member can receive?
Letters/Forms
Emails
VAT Phone Calls
"I want to report how the pharmacy employees treat me the other day."
Complaints or Compliments :: QAA
One-time payments made by advocates over the phone are performed in which Humana system?
eBilling
What demographic details does not requiered CMS verification prior a demographic change in CRM?
Phone number
What should you do if PAAG shows the requested provider is out of network?
Help the member find another doctor that is in-network
When caller refuses your assistance and ask for an onshore person, you transfer the CRM case directly to:
Escalated Caller Member Solutions Team
"How much it will cost me if I schedule a trip to my doctor's office?"
Transportation :: Benefits
Which premium payment method requires members to mail a voucher slip along with their personal check or money order?
Coupon Book
Members termed for moving Out of Service Area have a _____ to enroll in a new plan with Humana or another carrier.
Special Election Period
Who can be a PCP?
Family Practitioners
General Practitioners
What is included on the SmartSummary?
Claim Details
Rx Drug Details
Cost Share amounts
"Do I have Silver Sneaker program included in my plan?"
Benefits :: Rewards
To avoid termination, members with overdue premiums are offered which options?
Make a one-time payment in full over the phone
Send a letter explaining their situation to waived the past due
Send payment via overnight mail
What tool is used to verify demographic requiring CMS corroboration?
Wipro
What is a Grievance?
Humana doesn't meet member's expectations
Is a cost-saving measure that prevents members from receiving duplicate benefits when they have multiple insurance plans
Coordination of Benefits
"My last name is with double N. I want this corrected now"
Demographic :: Change