Team Members
What team member birthday is today?
Zanesha
What is the name of the system IL Recon is worked out of?
Paris
Can a member have 2 waivers at same time in Humana System?
No, they may have 2 waivers however we can only key one per month.
MER and MCD Plans match at all times. True or False
True
What screen shows waiver coverage in CI?
LTSS
Who has worked for Humana the longest?
Tonya
What determines the expected total payment?
Plan and BSN member is on in CI.
Member has waiver LTC. What BSN will member be on?
BSN 003
How many different groups do we have for IL Recon? MER and MCD.
5
What screen can you make pcp updates?
PAMG
Who has a Dog named Zoey?
Danita
The date on your DON is 12/01/2023. You update the true waiver screen. True or False?
False. we will receive full payment
DON received for 09/24/2024 for waiver A0. What date will waiver be effective on the LTSS screen?
09/01/2024. No matter when DON is received Waiver is for whole month.
When does the true waiver get updated?
What screen can be used to do a name search?
PESL
Which of our members do not reside in Kentuckiana?
Candace, Olivia, Aleshia and Misty.
The Date on your DON is 08/15/2024. Does the true waiver screen need to be updated?
Yes
What waivers can you find in MEDI/ RPA?
LTC/ FO
What does DON stand for?
Determination of Need
What screen do you use to send 4RX?
PRXM
Who bakes beautiful cakes on the side?
Alex
Received waiver for total payment for waiver A0. No DON on file, State System and 834 show no waiver coverage. Member is currently not on waiver in CI. What would your final result be?
Sent to enrollment and key waiver coverage to match 820 total payment.
Member is currently keyed to Waiver LTC for 05/01/2024 - current. DON Received for 09/15/2024 for waiver A0. Can we update to waiver A0?
Yes, a DON is the highest on the hierarchy.
List the Hierarchy for Waiver Coverage.
DON/ DOA Faxes, Market/ Care Managers, State, 834/820
What screen can you see if member had MBI change?
PMID