General
The four principles of Humana.
What is Know Me, Show me you care, make it easy, help me
This is used to verify identity.
What is Member ID number, DOB, and zip code.
This classification is used to resolve billing issues.
What is billing?
This system is used to locate INN providers.
What is PFP?
Always take the first opportunity to offer empathy.
What is empathy?
The number of steps in the call flow.
What is 8?
This protects PHI from being disclosed to unauthorized personnel.
What is HIPAA?
This intent is used to verify benefits for medical, dental, vision, hearing or VAIS calls.
What is verification?
This generates when a PCP is changed.
What is an ID card?
This means the auth is handled by a vendor
What is a blue hyperlink?
This step requires that you follow the appropriate mentor process
What is resolve the issue?
This allows someone other than the member to make changes.
What is a POA?
This classification is used to send out a consent form
What is HIPAA?
*Daily Double* Time frame to receive ID card after PCP change.
What is 7-10 business days?
*Daily Double* The contract ID is found on the medical policy page in CRM under this section.
What is eligibility information?
This step requires that you recap or restate the member's issue and confirm before proceeding to resolving the issue.
What is understand the issue?
*Daily Double* HIPAA stands for this.
Health Insurance Portability and Accountability Act.
This classification is used when a member wants to change their PCP.
What is PCP change?
This is filled out for each PCP change.
What is the PCP questions?
This screen in CI shows the level of LIS a member receives.
What is CLIS?
This is required for all deceased members.
What is an EOE?
*Daily Double* This intent is used to send out fulfillment such as an ANOC or PDG.
What is benefit information?
This provider provides hospital beds.
What is a DME provider?
Time frame a member can go without drug coverage.
What is 63 days?