Medicare
What is an Agent
A person licensed by state to place or enroll with different insurance companies
What plan types will you handle
Individual Medicare
Adherence
95%
POS
Point of service
Mentor
knowledge base
bible and best friend used on every call
Deductible
An amount a member has to pay before the benefits or insurance kicks in
Two type of Medicare parts Humana offers
Part C and Part D
Delivery
50%
DME
Durable medical equipment
re-usable
DEBUT
used to quote Medical Benefits
How to properly authenticate
Humana ID/ Medicare ID
DOB
ZIp code
what qualifies a person for Medicare
age-65 and over
if under 65 they have to have certain disabilities
ESRD
Humana Greeting
Thank you for calling Humana, my name is______ your healthcare advocate. How may I help you
Medicaid
Government funded plan that is offered to member with LOW income
QS+
capture notes Classification and intent and mentor Documents
Humana Customer
Member
member representative
agent
Provider
Medicare Parts
Part A, Part B ,Part C and part D
Recap and Closing
It's been a pleasure helping you with_____ is there anything else I can assist you with? Thank you for calling Humana we are always here to help
PPO
INN and OON
NO referral needed
PCP not on card
CRM and CI
communicates together
CRM take 24/48hrs to update
CI is live and used for manual upadtes
Contact Handling Alert
Assist advocate will member calls and instructions on how to handle a call
Guidance alert
For members and contains messages on how rely message including promoting programs
Provider Interaction
Provider search tab
NPI/TIN + name of provider + name of the caller + with
member search page
H#, DOB ZIP and + about
HMO
Health maintenance organization
referral/auth needed
PCP printed on card
INN only
GO2DIG BOT
select all the systems you will use
CRM edge
mentor edge
HODmod4