Ice Hockey
Where can we see if the call came in authenticated?
What is interaction log and Genesys phone
Where can the consent form or POA be found in CRM Service?
What is CRM Person Account Page under HIPPA Forms in the Associated Forms and Information Section.
According to COB Heirarchy rules, this carrier pays second or “coordinates” the remaining amount based on the amount covered by the primary plan.
What is Secondary Insurance/Carrier
It contains a list of in-network providers members can choose from for their healthcare needs
What is Full Provider Directory
A written verification typically requested by new members waiting for receipt of their Humana ID card.
What is Proof of coverage letter
used to order paper copies of benefit information such as handbooks and welcome kits
What is OMS (Order Management System)
What are three plan identifiers are used to pinpoint the item to order in OMS?
What is/are Contract, PBP, Segment ID
What is the classification and intent for ordering an OTC Form?
What is
C: Fulfillment
I: Letter/Form Request
Which Mentor document contains item number codes used to place an order in OMS?
What is OMS and OES Codes document
This is a tool that allows you to view an electronic copy of a member’s ID card (front and back)
What is ID Card Center.
A document explaining the member’s insurance plan with Humana where it explains plan benefits, coverage, rghts, responsibilities of the members as a member and as an insurer
What is Evidence of Coverage
How does Humana communicates with members? Give example/s of these communication methods
What is letters, forms, and outbound Voice Automated Technology (VAT) phone calls
This section/feature in CRM is accesed to view the recent correspondence/communications sent through EMME.
What is Real Time Interaction (RTI) Communication
his is verified before sending letter/email to members.
What is Email/Mailing address
This type of consent is only valid during that specific call occurrence and must ask directly from member to give permission to share information on their behalf.
What is Verbal Consent
a hard copy of Consent for Release of Protected Health Information (PHI) form is sent via ________.
What is Enterprise Measurable Messaging Ecosystem or EMME
This Alternative version is a complete audio substitute for print material and is specifically designed for use by people with blindness, impaired vision, and dyslexia.
What is Digital accessible information (Daisy)
These are the 2 reasond for using EMME.
What is/are Viewing and Creating Letters
True or False. You will only have to access EMME to view letters if CRM is not displaying a letter being referenced.
What is True
This is often referred as Robo Calls that notifies members of programs available to them, important health information, or reminders
What is Voice Automated Technology (VAT)
This page/screen in Customer Interface (CI) the Complete prescription drug plan Other Insurance (OI) details.
What is CI PEOC screen
VAT calls must also be logged in CRM by attaching them to a new or existing case. True or False
What is True
This Quick link at the top of the Plan Member page allows an advocate can view and update member communication preferences in CRM.
What is Member Preferences.
This feature in CRM notifies you if there is a direct communication that needs to be relayed/delivered to callers over the phone. If available to the member, an orange megaphone icon is visible.
What is Guidance Alerts
This is a monthly, personal health finance and benefits statement that includes a member's medical and/or prescription drug claim information.
hat is SmartSummary