Perfect Experience
This is added to the plan premium if member did not sign up for prescription drug coverage when they first eligible.
What Late Enrollment Penalty (LEP).
Where can the consent form or POA be found in CRM Service?
What is CRM Person Account Page under HIPPA Forms in the Associated Forms and Information Section.
According to COB Heirarchy rules, this carrier pays second or “coordinates” the remaining amount based on the amount covered by the primary plan.
What is Secondary Insurance/Carrier
Humana accepts credit or debit cards with a _____, ______, ____, or. ____ logo
What is/are Discover, Visa, MasterCard, or American Express
Authorized callers who can submit Grievances.
What is/are Member, Power of Attorney (POA), Appointment of Representative (AOR), Caller with Verbal Consent.
This is used to order paper copies of benefit information such as handbooks and welcome kits.
What is OMS (Order Management System)
What are three plan identifiers are used to pinpoint the item to order in OMS?
What is/are Contract, PBP, Segment ID
What is the classification and intent for ordering an OTC Form?
What is
C: Fulfillment
I: Letter/Form Request
This is sent to members if Humana does not receive premium payment 13 days after the due date.
What is Payment Reminder Letter.
This is a tool that allows you to view an electronic copy of a member’s ID card (front and back)
What is ID Card Center.
A document explaining the member’s insurance plan with Humana where it explains plan benefits, coverage, rights, responsibilities of the members as a member and as an insurer.
What is Evidence of Coverage
How does Humana communicates with members? Give example/s of these communication methods.
What is letters, forms, and outbound Voice Automated Technology (VAT) phone calls
This section/feature in CRM is accessed to view the recent correspondence/communications sent through EMME.
What is Real Time Interaction (RTI) Communication
This is verified before sending letter/email to members.
What is Email/Mailing address
This type of consent is only valid during that specific call occurrence and must ask directly from member to give permission to share information on their behalf.
What is Verbal Consent
A hard copy of Consent for Release of Protected Health Information (PHI) form is sent via ________.
What is Enterprise Measurable Messaging Ecosystem or EMME
This Alternative version is a complete audio substitute for print material and is specifically designed for use by people with blindness, impaired vision, and dyslexia.
What is Digital accessible information (Daisy)
These are the 2 reasons for using EMME.
What is/are Viewing and Creating Letters
True or False. You will only have to access EMME to view letters if CRM (RTI Communication) is not displaying the letter being referenced.
What is True
This is often referred as Robo Calls that notifies members of programs available to them, important health information, or reminders.
What is Voice Automated Technology (VAT)
This template is filled out if the complaint is about Provider's Quality of Care and Attitude.
What is QAA Template.
VAT calls must also be logged in CRM by attaching them to a new or existing case. True or False
What is True
This Quick link in the Plan Member page allows an advocate to view and update member communication preferences in CRM.
What is Member Preferences.
This feature in CRM notifies you if there is a direct communication that needs to be relayed/delivered to callers over the phone. If available to the member, an orange megaphone icon is visible.
What is Guidance Alerts
This is a monthly, personal health finance and benefits statement that includes a member's medical and/or prescription drug claim information.
What is SmartSummary