WAVE 1
What is the mentor document used to get extensions to transfer calls?
Medicare Phone Number
What tools can we use to quote benefits?
DEBUT
BENEFIT GRID
INDIVIDUAL MEDICARE EVIDENCE OF COVERAGE
WHAT IS EXTRA HELP?
What is the tool I use to request ID cards?
ID card management
what link can we use to check dme coverage?
go/coverage.
ABOUT OVERRIDES:
WHAT OVERRIDES ARE WE ALLOWED TO DO?
WHAT ARE THE ERROR CODES FOR THOSE?
MAIL ORDER DELAY 080
COB 090
How do you authenticate when a provider is calling in?
NPI, Caller´s name/ Humana ID, first and last name, ZIP and DOB
what's the process that we must follow when a member express dissatisfaction about something other than the way that a claim or a medical or pharmacy authorization processed.?
File a Grievance / Member Grievance and Appeal for Medicare Calls Overview
DURING THE COVERAGE GAP, WHAT AMOUNTS COUNTS TOWARDS THE TrOOP?
During this stage, the manufacturer discount amount for brand drugs counts towards TrOOP amount. To meet their TrOOP while in the gap, the member starts at the amount that they paid out of pocket only (not including what Humana has paid).
Do member who have PPO plans need referral to visit specialists?
No
What's the tool that we can use as a directory of resources across the U.S. that address the social needs of our members?
Humana Community Navigator
NAME 3 IMMUNIZATIONS COVER UNDER PARTD D
Hepatitis A
Respiratory Syncytial Virus (RSV)
Shingles (Herpes Zoster)
What is the classification and Intent when I need to change the address?
Demographics-Change
What's the name of the mentor document that provides detailed information on plan benefits, including limitations and exclusions.?
Verification of Benefits (VOB) Medicare Overview
WHY THIS CLAIM IS DENIED?
SEE IMAGE