Humana Jeopardy

Benefits

100

Mentor document for a ride to a doctors appointment in South Carolina.

South Carolina Medicaid Nonemergent Transportation Call Guidance (humana.com)

200

A device that produces a fine spray of liquid used for inhaling a medicinal drug (for example, asthma medication).

A nebulizer

300

Department and phone number for requesting sign language interpreter for doctors visits

• Humana Concierge [phone]

400

First dermatologist on PFP for zip code 40217

Norton Cancer Institute on 2355 Poplar Level Road

500

Program used to ship an OTC catalog and form to an Illinois MMP member

EMME

Authorizations

100

Authorization timeframe for a retro authorization in South Carolina

30 calendar days

200

Department for inpatient mental health authorization in KY

Humana Behavioral Health

300

Document used to determine the status of an authorization in Illinois

Medical Preauthorization and Referrals Status Calls Medicare and MMP (humana.com)

400

Vendor used for chiropractic service authorizations in KY

WholeHealth Networks (dba Tivity)

500

Department for Medical Records considered during an authorization review process

• • Service Center: Green Bay
• • Department: Grievance and Appeal
• • Topic: Verbal Appeal

Claims

100

CAS screen used to locate claims using the month and year

MDI Claim Screen

200

What is the process for claims questions regarding DOS 12/31/2019 or earlier in Kentucky?

• Callers with questions on a KY Medicaid claim before January 1, 2020, advise the caller to submit as correspondence.

300

Member Resolution for claim denial code 27G

Advise the caller that the payment for this service was denied because medical records have been requested but have not been received.  Advise caller the medical records are needed to have service(s) reconsidered for payment.

-Make an outbound call to the provider. Advise provider that medical records are needed to have payment for denied service reconsidered. 

400

Process for Illinois MMP:LTSS Claims Denying R4K

• If an Illinois MMP member calls about a claim for home maker services that was denied
• a. Search for the claim and validate the reason for the denial. Refer to Claims Determination Overview.
• b. If the deny code is R4K,
• i. Advise that you're sending the claim for reprocessing.
• ii. Send a CRM case to CRU with a request to reprocess the claim
• c. Provide the applicable grievance rights if the caller expresses dissatisfaction.

500

When some line items are paid and some are denied, what status should be quoted to the member?

Paid with Adjustments

Humana Services for Employees

100

What is the name of the program we use for wellness rewards?

Virgin Pulse

200

Where can you go to report a non-emergent tech issue?

ITSD - Report an Issue - Associate Support Center (service-now.com)

300

What is the name of the vendor who provides the education benefit including free courses and tuition reimbursement?

Guild

400

What is the name of EAP program for mental, financial, physical, and social assistance?

TELUS Health

500

How many NRGs are available at Humana?

10 (Access, Caregivers, GenUs, HAPI, Impact, Native American and Indigenous Peoples, Pride, Salute, Unidos, and Women)

Humana Policies

100

What programs must you use to request time off?

Start with WFO, once approved, then Workday

200

How many Humana company holidays are there?

8 (New Year's Day, MLK Jr Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, Black Friday, Christmas Day)

300

How many hours of volunteer time off do full-time Humana employees get each year?

8 hours

400

Where can you go to apply for financial support and assistance when facing a tragic, isolated, or unforeseen life event causing unusual and severe financial hardship?

go/helpinghands

500

How can you apply to be a bilingual or multilingual associate?

Request to schedule a Proficiency Assessment by email to [e-mail]