Customer Interface Commands
What is the Customer Interface command/ screen where you can find out if the member is involved in Mass Moved Members?
MACH
What is the name of the vendor of Humana for spending card benefit?
Solutran
What is reinstatement?
is the process where a termed member returns back to their usual policy.
This is the term reason when the member was reported dead in the system even though the member is still alive.
Erroneous report of death
This is the tool that uses _______ to open the paper document that the member sent to us.
DCN - Document Control Number
Before you process a Demographic Change in Customer Interface, you are told by mentor to create a task first before you can make changes. What is the command that you use to create a task in Customer Interface?
PATR
What are the two types of spending card benefit?
OTC Allowance & Healthy Options
In order for the member to be reinstated they have to qualify for several election periods. What are those election periods?
Annual Election Period
Open Enrollment Period
Special Election Period
Initial Coverage Election Period
Integrated Special Election Period
Open Enrollment period for Institutionalized Individuals
This is a term reason that commonly happens when the members change their residential address.
Out of service area
This is the tab in CRM in which we use if the member asks their application status and all they provided is their SSN?
Automated Enrollment
What is the command that we use to check and see if the SSN that the member provided matches what we have in the system?
PEDM
What is the number that changes every time we send a replacement card and why is it necessary to change?
Account Card Number
Among the 4 POA types, which among them are allowed to process a reinstatement process?
C & H
What does ERC Stand for?
End Reason Code
What is the tool that we use if the member sent their application through mail or paper?
Marketpoint
What is the command that we use to check the other insurance information of the member and what is the combination of keys that we use to navigate through that screen?
PEOC & SHIFT + F8
On which tab on Solutran can you check the reason of the denial in the spending card claims?
Transaction History
According to mentor, what is the plan type that automatically does not qualify for good cause reinstatement?
MA/MAPD
What are the two types of disenrollment?
Involuntary & Voluntary disenrollment
What is the mentor document that we open if the call is about termination codes and it's meaning?
Medicare Termination Calls
What is the command that we use to check the status of a disenrollment request & reinstatement request?
PAIG & MREP
What is the name of the process in which we help the member recover the amount that they were not able to use?
Rollover Request
This is a type of reinstatement reason where members are provided a chance to be reinstated as long as they have a valid reason?
Good Cause Reinstatement
What is the difference between cancellation and disenrollment?
Cancellation is cancelling or ending the future plan while disenrollment is cancelling or ending the current plan.
What is the name of the new vendor of Humana for spending benefits?