General
The five principles of Humana
What is Know Me, Show me you care, make it easy, help me
This screen is known as home base
PAPI
This is used to verify identity.
What is Member ID number, DOB, and zip code.
This system is used to locate INN providers.
What is PFP?
Always take the first opportunity to offer this.
What is empathy?
The number of steps in the call flow.
What is 8.
This screen is used to change demographics
PEDM
This protects PHI from being disclosed to unauthorized personnel.
What is HIPAA?
This generates when a PCP is changed.
What is an ID card?
This is shown on the grid for SNP DE members.
What is a stop sign?
This step requires that you follow the appropriate mentor process
What is resolve the issue?
This screen is used to create a task
PATR
This allows someone other than the member to make changes.
What is a POA?
*Daily Double* Time frame to receive ID card after PCP change.
What is 7-10 business days?
*Daily Double* The group number is found on the medical policy page in CRM under this section.
What is policy details?
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?
This screen is used for LEP information
PCCV
*Daily Double* HIPAA stands for this.
Health Insurance Portability and Accountability Act.
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?
The 4 categories in ECHO are directly affected by the CCS.
Agent Satisfaction, Agent Courtesy, Agent Knowledge, Issue Resolution.
This screen is used to locate a member by name
PESL
Authentication verifies this of the caller.
Identity and authority (consent)
This provider provides hospital beds.
What is DME provider?
Time frame a member can go without drug coverage.
What is 63 days?