It is October 2nd and you, the agent, are speaking with Doris. Humana may terminate upon discovery and report incidences of submission of applications by unlicensed agents and brokers to the authority in the State where the application was submitted as well as to CMS. Note: questions about passing the final exam are only in this practice exam, The agent clicks the test submit button or the test timer reaches 35 minutes. In which of the following situations is it acceptable for an agent to use their own email address for an applicant? Find budget-friendly plans for your company’s most valuable asset: your employees. You can expect your refills to arrive 5 to 7 days after placing your order. She is requesting to enroll in a Humana Medicare Advantage plan today. Agent Juan is enrolling Mrs. Maples into a HMO plan. If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800 … The applications will be denied and marked for investigation. If you shop at one of our Humana Pharmacy retail locations and have a question, we're here to help. Eye exams for glaucoma and macular degeneration—to common age-related conditions. He is meeting with Agent Wayne and Oscar is requesting to enroll in a Humana MAPD plan in the 3 months prior to his Part B effective date. Jan. 1, 2019, Part B Step Therapy Preferred Drug List – English, PDF opens in new window. Under what circumstances is it Under what circumstances is it acceptable for an agent to complete an Agent Online Application, or AOA , application on behalf of their client? To assist enrollees and members in making an informed decision about providers that help members achieve the best possible health outcomes. Which of the following is an advantage for new members when they pre-register with Humana Pharmacy? Dr. Grayson is part of the American Medical Group. Choose the answer that best explains the Telephonic Presentations policy. Which of the following is considered marketing material and requires CMS approval? To be compliant with state and local regulations, what change will Humana Pharmacy members see to their. once per year). If you’re performing a test that detects the flu via immunoassay in the office, your provider might test for two The 87804 code represents “a testing … Humana group vision plans are offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Health Benefit Plan of Louisiana, Humana Insurance Company of Kentucky, Humana Insurance Company of New York, CompBenefits Insurance Company, CompBenefits Company, or The Dental Concern, Inc. Humana group life plans are offered by Humana Insurance Company or Humana Insurance Company of Kentucky. Do you qualify for Extra Help with Medicare costs? Initial Coverage Enrollment Period (ICEP). How should you guide Mr. Green? Which of the following statements best describes Go365? She tells Agent Sarah that she would like to enroll in a MA-only (no RX). ​To be compliant with state and local regulations, what change could Humana Pharmacy members see to their prescription costs? Applicable tax or taxes will be applied to all applicable prescription orders. Form 8-Ks filed during 2019. Mrs. Maples wants to select Dr. Grayson as her PCP. Agents are responsible for all applicable insurance licenses and any applicable certifications required to sell a corresponding Humana product in all states in which the agent markets such products, ICEP is for enrollment into MA/MAPD only. They said... Humana - Complaint Oct 13, 2019 … Humana legal entities that offer, underwrite, administer or insure insurance products and services, View a complete list of the legal entities. Is there a difference in length between the Telephonic Presentation and the in-person presentation? MA enrollees using the Medicare Advantage Disenrollment Period (MADP) to disenroll from their MA plan are eligible for a SEP to enroll in... How many questions are on Humana`s final exam and what material do they test on? For detailed information about Humana’s claim payment inquiry process, review the claim payment inquiry process guide (300 KB)., PDF opens new window. When a beneficiary moves out of a plan`s service area, when must they enroll into a plan servicing the new area to avoid a lapse in coverage? Agent Mike is speaking with Betty Ann and she is asking how to determine if her medication is covered by Part B or Part D. What is the preferred way for Agent Mike to determine if a medication is on Humana's formulary? Agent Nicky conducts educational events at Dr. Singh`s office throughout the year. Fill in the blank. Jan. 1, 2019, Medicare and Dual Medicare-Medicaid Plans Preauthorization and Notification List – English, PDF opens in new window. Slim-down successfully by setting realistic goals and making your weight-loss journey an enjoyable trip. What should he do? Which enrollment period should Agent Wayne select for Oscar's application? TTY users should call 1-877-486-2048, 24 hours a day/ 7 days a week or consult www.medicare.gov; the Social Security Office at 1-800-772-1213 between 7 a.m. and 7 p.m., Monday through Friday. On-site pharmacy information. There you can also use the physician finder and get health news and information. For costs and complete details of coverage, call or write Humana or your Humana insurance agent or broker. You can expect your refills to arrive 5 to 7 days after placing your order. When can agents begin marketing to non-renewing members? In your form, you will need to explain your rationale for making this request, including a clinical justification and referencing any relevant lab test results. The Telephonic Presentations policy provides guidance for licensed, appointed and certified sales agents representing a Humana Medicare Advantage (MA), in a non-call center setting, to perform a compliant telephonic Medicare sales presentation, Fill-in the blank: For events advertised to the general public, a Scope of Appointment (SOA) is, For events advertised to the general public, a Scope of Appointment (SOA) is not required, as the advertisement serves as a collective SOA. Which of the following is the best example of what an agent should do to explain a plan's drug benefit? What is this called? Note: questions about passing the final exam are only in this practice exam. Agent Deborah must explain in and out of network benefits and any possible Independent Provider Association (IPA) affiliations of their selected PCP. Use Humana's RX look up tools to determine if a medication is on Humana's formulary. View plan provisions or check with your sales representative. If you have cardiovascular problems or diabetes, you may need a test every year. Fax: 1 (800) 555-2546; Phone: 1 (877) 486-2621; Humana … Use Humana's Physician Finder Plus to see if the provider is in Humana's network. The Center for Medicare & Medicaid Services (CMS) announced in CR11080 that these apply to facilities with a CLIA certificate of waiver. It allows members to obtain pricing for medications based on their future effective date. Humana individual dental plans are insured or offered by Humana Insurance Company, HumanaDental Insurance Company, Humana Insurance Company of New York, The Dental Concern, Inc., CompBenefits Insurance Company, CompBenefits Insurance Company, CompBenefits Company, CompBenefits Dental, Inc., Humana Employers Health Plan of Georgia, Inc., Humana Health Benefit Plan of Louisiana, Inc., or DentiCare, Inc. (DBA CompBenefits). Which of the following is considered marketing material and requires CMS approval ? Our promise is to provide more than health insurance plans. and Saturday 8 … Why is it important for agents to offer guidance for provider selection? The benefit allows for one annual routine hearing exam at no cost to the … If you don't receive your medication-or just want to check on your order-you can call Humana Pharmacy at 1-800-379-0092 (TTY: 711), Monday to Friday 8 a.m. to 11p.m. Individuals who belong to a qualified SPAP are eligible for an SEP to make one enrollment request at any time through the end of each calendar year (i.e. Discount plans are offered by HumanaDental Insurance Company, Humana Insurance Company, or Texas Dental Plans, Inc. Arizona residents insured by Humana Insurance Company. For dates of service beginning April 1, 2020, use the new code published by the CDC, as appropriate (New ICD-10-CM code for the 2019 Novel Coronavirus (COVID-19), April 1… Learn about enrolling in your employer plan and find resources and support to make the most of your benefits. Agent James is enrolling a prospect into a Humana Medicare Advantage plan and it is time to choose a PCP. Individuals who belong to a qualified State Pharmaceutical Assistance Program (SPAP) are eligible for an SEP to... Make one enrollment request (both MAPD and PDP) at any time through the end of each calendar year (i.e. Which of the following statements is true regarding the Primary Care Provider (PCP) Change form? April 1… Who is responsible for all applicable insurance licenses and any applicable certifications required to sell a corresponding Humana product in all states in which the agent markets such products? The modifier QW CLIA waived test … Fill-in the blank: For events advertised to the general public, a Scope of Appointment (SOA) is _________. Agents must explain In and out of network benefits and any possible Independent Provider Association (IPA) affiliations of their selected PCP. This plan includes additional Medicare prescription drug (Part-D) coverage. Carol delayed Part B and wants to enroll in a Humana MA plan (No RX). Agent James is enrolling a prospect into a Humana Medicare Advantage plan and it is time to choose a PCP. In the event of a dispute, the policy as written in English is considered the controlling authority. Agent Ben should have checked to see the provider was contracted for the HMO plan. Tamara is aging into Medicare and is in her 7 month initial election period. In which of the following situations is it acceptable to create an Email address for a beneficiary? For details on … Many Humana Gold Choice Plans combine all the benefits of Original Medicare with prescription drug coverage and more.-Affordable monthly plan premium 40 coverage for most annual screenings.-Humana … Asking the beneficiary to consult with their doctor or pharmacist to obtain generic medications that are covered on the formulary. Agent Todd can't. Agent Anna enrolled a prospect in a Humana MAPD plan for Nebraska. CMS expects agents to provide a clear, concise explanation of the plan's drug benefit. Plans, products, and services are solely and only provided by one or more Humana Entities specified on the plan, product, or service contract, not Humana Inc. Not all plans, products, and services are available in each state. For dates of service prior to April 1, ... to have COVID-19, and the test results for the exposed individual are either unknown or negative. Agent Ben knows that Dr. Mendez is in network for a PPO plan in a particular service area. The purpose of the Non-Discrimination notice is to inform people about their ability to receive information in another language and give directions on how to file a complaint should they feel they have been discriminated against. Talk to your doctor about your physical activity.