Systems
This system is used to check for medical, dental, and other insurance benefits
Debut
What is available for members to access on their mobile phones to manage many areas of their healthcare including medical coverage, prescription information, finding a doctor, and viewing their medical ID card.
Humana Mobile App
This search engine that allows you to locate internal guidelines relevant to your role. This is also used throughout training and during live calls to reference call handling procedures.
Mentor
If the member cannot be found using any search option, document the call this.
Unknown Member
Annual Enrollment Period (AEP) occurs between THESE DATES annually. This is when Medicare beneficiaries get to decide if they want to keep their current coverage, switch plans, or switch insurance carriers altogether.
October 15th and December 7th.
This system is used to check for claims (in depth)
CAS
Humana wants us to minimize this during every call.
hold time and dead air
Logging in to this is a part of every advocate’s daily setup. This also allows you to quickly navigate to the other systems.
DIG Toolbar
In order to speak with someone other than the member. We need to verify something, what do we verify?
(hint) 3 possible answers
Verbal Consent
Consent
POA
MA Annual Open Enrollment Period (OEP) occurs from THESE DATES. It allows individuals enrolled in a Medicare Advantage plan to make a one-time election during the first 3 months of the calendar year to switch Medicare Advantage plans or to disenroll from a Medicare Advantage plan and return to Original Medicare.
January 1 through March 31.
This system is used to check for providers to see if there in network and accepting new patients
Find Care
This company is used to schedule transportation in MI
Safe Ride
This provides a complete view of each member account by compiling information from over fifteen Humana systems.
Customer Relationship Management (CRM) Service application.
This is a legal document signed by a member to allow another party to act on a member’s behalf.
POA
Members needing help shopping for Medicare plans are connected to this team for a licensed agent to further assist.
DMS team
This system is used because a member needs another Spending Card
Nations Benefits
This company is used to schedule transportation in IL
MTM
This is the second tool that is used on every call. It's used to document details specific to the caller's issue or concern.
Quick Start+
Understanding what this is and key behaviors to look for are essential for safeguarding the sensitive information our members entrust us with.
Bad Actor
This is our scripted greeting for humana calls.
Thank you for calling Humana. My name is ___________, your healthcare advocate. How may I help you? "
This is another system that communicates directly with Customer Relationship Management (CRM).
Customer Interface (CI)
This company is used to schedule transportation in SC
Modivcare
In most cases when handling live calls, member information automatically displays in this to verify with callers.
Member Search tab
To enroll in this, a person must do the following:
Have Medicare Part A & Part B (at the time of enrollment or will have within the next 3 months.)
Live in the plan’s service area.
Medicare Advantage plan.
This is our scripted end statement for humana calls
It's been a pleasure helping you with (the reason for the call). Thank you for calling Humana, we're always here to help.