OEP
Do we promote the OEP?
NO!!!!
Which tools do we use for RX benefits verification.
+100 When do we use each one.
Rx Connect Pro
Rx Nova Call Connect
Humana Pharmacy Calculator
What's the tool we use to fix Web problems?
Digital Access Manager (DAM)
Which mentor document do we use in every Benefits call
Verification of Benefits Table of Contents
Who has the most valid sick leaves
Ivonne
From when through when does the OEP is available.
If you need to create a Rx Prior Auth which tool, would you use.
Prompt PA
Are passwords through different Humana adjacent apps different from the MyHumana password?
No!!!
Describe the VOB Cycle
1-Verify benefit
2-Check if auth is needed
3-Verify providers
When's Ivan's birthday
May, 21st
Who can make changes to the plan during OEP?
+100 Which POA types can make plan changes
Member or POA (Type H, Type C)
edit to hippa
1- Go to a claim on Rx Nova
2- Click on verify coverage
3- Copy prescriptions information
4- Select new fill date
What mentor document do we use when an account is Hard Locked after doing an MFA reset on DAM
Escalate an Issue to Access Management and we complete the TFA/MFA Assistance from.
Do we cover acupuncture?
Yes!! If member has either of the following
1- Chronic Low Back Pain (CLBP)
2- Mandatory Supplemental Benefits (MSB)
3-Value Added Item and Services (VAIS)
Who's Loany's favorite
None!!!
How many times can I change my plan while the OEP is available.
One time
When do we offer a tier/drug list exception?
Specific requests: "I would like to request a tier/drug list exception for..."
General requests: "I can't afford my drug copayments this year..."
What's the process if member forgot their password?
1- Go to DAM
2- Click the reset password box on the left side
3- Create and confirm a temporary password
4- Give this password to the member
5-Advise member to create a new password.
How do we quote CGM (Continuous Glucose Monitors)
We search Continuous Glucose Monitors on Debut and advise of the preferred providers.
What's Ivan's second last name
+100 If you can say his second name
Alexis Hernandez
Does LIS (Extra Help) eligibility transfer from plan to plan when changed during OEP.
If a member moves from a Humana plan to another Humana plan, Extra Help (or LIS) information transfers to the new plan.
So yes!!
How do we solve a '' 090 '' error code?
We process a 090 override and complete the OI template in CRM
What do we do when this message shows up
"Oops! It appears you don't have any active coverage. If you believe you're seeing this message in error, please call the Customer Care number on the back of your member ID card."
Advise member we need to escalate this case.
We complete the MyHumana Account Lockout form
Select Web Site Error Message from the Issue drop-down in the form.
Note in the description your CRM Interaction ID and the complete error message that the member has received.
Keep the CRM case open to call member back once Help desk fixes the problem.
The medication for infusions is taken as part B?
Infusion is taken as surgery and then the medications are covered under part B benefits
What's Ihan's true schedule
10 a.m - 7 p.m