Show:
Medical Benefits
Auth/Referral
Web & Mobile
Mentor
Miscellaneous
100

What tool would you use to locate the members benefits?

Debut
100

Does a member need a referral to see a otolaryngologist? 

No

100

What can we never GIVE the member to assist them with signing in?

Username

100

What is the name of the mentor we have used in training that list all the mentors by category in alphabetical order?

Medicaid Calls Document Index

100

True or False: If a member ask not to be recorded we have to document that call.

True

200

If a member is calling about their dental benefits what would you quote?

Nothing. You would advise them to contact OHCA or their Dental carrier.

200

True or False: Humana handles all authorizations.

False

200

True or false: The username must contain at least 1 uppercase, 1 lowercase and 1 number?

False

200

From the Index what mentor would you start with for a Medical benefits call? 

Verification of Benefits Medicaid and MMP Overview

200

How many times can a member attempt to put in their MyHumana.com password before it locks them out?

5 Times

300

What are the base services that are covered with Personal Care?

Services include but are not limited to, assistance with:

  • Personal hygiene
  • Dressing
  • Medication
  • Meal preparation
  • Light housekeeping
  • Errands
  • Laundry directly related to the member's personal care needs
300

If a member already had services performed and are inquiring if they can submit an authorization for these services, what would you advise?

Yes they can, it is called a Retro Authorization.

300

What three Humana websites can member navigate securely?

Answer: Humana.com, Go365.com, and HumanaPharmacy.com

300

What is the mentor for Oklahoma phone numbers? 

Oklahoma Medicaid Phone Numbers

300

What are 3 things other then the members full name needed to authenticate the member? 


  • UMID/SSN/Medicaid number
  • Member’s date of birth
  • Member's ZIP code
  • Member's group name, group number, or product type (only if needed)
400

What are the expanded benefits for OTC?

Up to $30 per household per quarter allowance enables households to purchase products that support common occurring conditions such as:

  • Pain relivers
  • Diaper rash cream
  • Cough and cold relief medicine
  • First aid equipment that do not require prescriptions.

    Unused amounts do not roll over to the next quarter.
400

What three ways can a provider submit an authorization or referral to Humana?

Provider Web Specialist, Phone, Fax

400

If a member is needing their password reset what tool will you use? 

CSR PasswordReset

400

What is the state specific mentor for Oklahoma when it comes to Eligibility calls? 

Eligibility Verification and Access to Care for Oklahoma Medicaid

400

Before mailing out a new ID card what are 2 things that you have to verify?

Address and PCP

500

What are the exclusions for Telehealth services per Debut?

Exclusions

Not covered: Physical therapy, occupational therapy, and/or speech and hearing services as a part of telehealth

500

Using the mentor: Medical Authorization and Referral Calls Florida Medicaid, If a member calls in to check status of an authorization what step do we go to after step 1?

Go to the Status Calls section.

500

What are the 4 different characters the member can use in their myhumana.com password?

May include the following characters: #, $, *, or @

500

What is the mentor that we use for guidance with the Digital Onboarding Experience?

MyHumana Account Setup - Digital Onboarding Experience

500

What are the PARE providers?

P-athologist
A-nesthesiologist
R-adiologist
E-R Physicians