CAT A
What was the lesson we just completed
Active listening
To allow yourself to feel what the next person feels
Empathy
Name the 3 types of claims forms?
CMS-1500
UB-04
Superbill
Describe a CPT code?
5-digit numeric code
What is a CAS cause code?
Categorizes claims by the main diagnosis/ICD-10 code
Question technique
Open ended question
How do you let the member know you're listening to them?
Verbal nods
We should never give the member _____
Home work
We should avoid these types of statements
Negative
what is Dignity
The way a person feels about themselves
a sense of pride in oneself
What does TED stand for?
TELL, EXPLAIN, DESCRIBE
The point of active listening is to?
Understand
Humana values
Curios, caring committed
Care model focuses on these call types
Provider locate and PCP changes
What is the MDI control line?
MDI,ID,suffix,first name,ee,MMYY
What does the accronym C.A.R.E mean
Connect, Appreciate, Respond, Empower
Give the speaker this
Undivided
What type of callers does Humana receive
members, member representatives, provider, agents
What is the purpose of open-ended questions?
Encourage members to elaborate/story telling
not yes or no questions
What is the 03 Bucket for on the MAI screen?
Combined MOOP amounts
What is the standard closing?
Thank you for calling humana we are always here to help
How do you mirror what a member has told you?
repeat, rephrase and paraphrase
Creating ______ of care, help us puts care into action
Moments
MHI control line
MHI,ID,,first name,ee
What is the modifier to check the frequency or type of bill code to confirm if the claim is original or corrected?
HDR2