Tool Usage
Who is your best friend when taking calls?
MENTOR
What does a Medicare Advantage plan include?
Medicare part A and B plus extra benefits (Dental, vision or hearing)
How is Medicare divided?
Part A, B, C and D
What type of callers does humana receive?
Members, Member Representatives, Providers, Agents
Green
Where do we open DIGBOT from?
Launchpad
This type of plan allows you to have only 1 Primary Care Physician (PCP), and you require a referral to visit a specialist?
HMO
Part A & Part B
What is the most important soft skill an advocate MUST have when speaking with a humana member?
Empathy
Which are the Humana Values?
Curious, Caring and Committed.
What is your main system/tool when taking calls?
CRM
This type of plan allows you to visit any doctor as long as it is in network (IN) with humana without the need of a referral.
PPO. Some PPO plans let you visit Out of Network doctors too (OON)!
What does Medicare Part C include?
What would you do if your caller is a New Humana Member?
Follow the New Member Call Flow. Bonus $100 if the agent gives the mentor.
List 4 qualities of a good advocate
Active Listening, Patience, Empathy, Understanding, Professional
What are the 3 tools that you MUST open every day through DIG BOT?
CRM, DEBUT, CI
What is the name for a humana plan that has both Medicare and Medicaid?
DUAL-Eligible
What is Medicare part C Called?
Medicare Advantage
What is the one thing we care MOST about our calls?
The Member Experience
What does CMS stands for?
Center for Medicare and Medicaid Services
Name 3 tools you would use in your calls. (Not including CRM, Genesys, Mentor or OTP)
EBilling, Debut, ID Card Managment System, Find Care, Physician Finder, Provider at a Glance (PAAG), RXNova, Rx ConnectPro
What type of plans/calls do you NOT take?
Florida H1036, IPA, Duals, Dental, Vision, MedSup, HIDE/FIDE, Careplus.
What part of Medicare does the member NEED to have, or would otherwise face a Late Enrollment penalty?
Medicare Part D
What is one way Humana measures member satisfaction?
CAHPS surveys
What is the name for our learning plataform?
LMS / CSOD
$100 EXTRA IF: GO/LMS