Hippa
What mentor job aid can we use to verify HIPPA authority?
HIPPA Job Aid
What main mentor should we access for VOB calls?
Verification of Benefits (VOB) Medicare Overview
What Overview Mentor do we access for authorization calls?
Medical Preauthorizations and Referrals Overview Medicare and MMP
What overview would we access for Fulfillment calls?
Fulfillment Overview
What mentor would we follow for guidance on how we handle our calls step by step?
Medicare Member Call Flow
Per Mentor, what can be disclosed without validating identity and authority for Billing related questions?
Minimum necessary to obtain premium payment.
Premium payment information
Balance Due
What mentor would we follow if caller is requesting assistance with scheduling transportation?
Routine Nonemergent Transportation Overview
What mentor would we follow about a member starting a preauthorization?
Medical Preauthorization and Referral Initial Calls Medicare
What mentor would we access if member calls about a VAT call they got from Humana?
Automated Calls, Emails, or Letter for Medicare Overview
What mentor can we access for updates on issues related to customer service?
Medicare Hot Topics
What mentor would we go to if member cannot give verbal consent due to being unconscious or not mentally able to, etc?
What mentor would you access if caller is having Access to Care issues?
Nurse Advice Line Overview
What mentor shows us the different vendors that handles preauths and their information?
Business partner (Vendor) Information List
If we need to resend an Annual Notice Of Change document and it is not in RTI what mentor would you access to send it through OMS?
OMS OES CODES INDEX
What mentor would we access to assist a member with activating a MyHumana Account?
Humana.com Account Activation and Sign in Overview
Per mentor, can we send the member an ID card via email?
No we cannot.
Per which mentor would tell us if Continuous Glucose Meter is covered under Part B or D?
Diabetic Care Overview
Per Mentor, which vendor handles primarily Continuous Glucose Monitors?
CCS Medical
Member calls in and wants to change how they receive their mail, what mentor would you follow?
Member Communication Preferences Medicare
Per Mentor Primary Care Physician Changes for Medicare Overview, what CI screen do we access to change a PCP in CI for a PPO member?
PAMG screen
What PHI information can we provide to a caller calling about a deceased member?
Nothing without an Executor of Estate document on file
What mentor would we need to follow if a caller calls in to check how much they have accumulated towards their Deductible/ MOOP?
Medicare Accumulations Overview
What website can a member go to if they want to appeal and authorization online?
Per Mentor, what Humana.com link can a member access their plan documents?
What mentor shows us our Required Greeting to use?
Standard Call Greetings or Medicare Member Call Flow