Notes

Write
Caller's Name:danielle
Callback #:516-222-8600 ext 320
UMID:H49536424
TAX ID:273629386
Reference #:267001310110

Issue/Concern: Caller is calling about Claim status.

DOS: 08/13/2014
Charge Amt: $165.00
Claim #:038492768
eob- 11/12/2014
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim denief or 08A// send back for review// primary eob is seen in maces image on page 2// ps review thank you// TAT: 30-45 B.DAYS//

Were G and A rights given? No.
01
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Caller's Name:theresa
Callback #:757-233-4521
UMID:h56215155
TAX ID:541547408
Reference #:994927000810

Issue/Concern: Caller is calling about Claim status.

DOS: 12/22/2014
Charge Amt: $2896.02
Claim #:056309778

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim denied for 0SO - OUTPATIENT CLAIM PAYMENT HAS BEEN ADJUSTED TO ACCOUNT FOR INPATIENT CHARGES// no inp claim on file for DOS// send back for review to cru// thank you//

Were G and A rights given? No.
02
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Caller's Name:keisha
Callback #:770-237-3000 ext 309
UMID:103158675
TAX ID:581949171
Reference #:445016371910

Issue/Concern: Caller is calling about benefits.

92557
92567
92579
92585
31231
31237
31575

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: logged vob//moop logged//
auth is not required//logged elig//
Were G and A rights given? No.
03
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Caller's Name:metilda
Callback #:877-261-1068 ext 6887
UMID:H47370484
TAX ID:742236469
Reference #:779741432610

Issue/Concern: Caller is calling about Claim status.

DOS: 11/26/2014
Charge Amt: $408.02
Claim #:142036480

Expected Outcome:To provide accurate information.142036480

Systems used: GCP

Actions Taken: claim logged// claim info given//

Were G and A rights given? No.
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Caller's Name:metilda
Callback #:877-261-1068 ext 6887
UMID: 101618257
TAX ID:742236469
Reference #:779741432610

Issue/Concern: Caller is calling about Claim status.

DOS: 11/24/2014
Charge Amt: $187.00
Claim #:201412266004335

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//

Were G and A rights given? No.
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Caller's Name:jill
Callback #:717-733-5937
UMID:H52974435
TAX ID:231370494
Reference #:783214284610

Issue/Concern: Caller is calling about Claim status.

DOS: 12/18/2014
Charge Amt: $68789.69
Claim #:056933810
auth #: 069353249
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//4F - PAYMENT HAS BEEN DENIED BECAUSE YOUR REQUEST FOR AUTHORIZATION WAS NOT APPROVED. PLEASE RE-SUBMIT ALL APPROPRIATE OUTPATIENT CHARGES ON A SEPARATE BILL.// cit: 800-523-0023// contacted cit and talked with mary// was advised that auth 069353249//will send this back to cru for review// thank you// TAT: 30-45 b.days//
Were G and A rights given? No.
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Caller's Name:maryanne
Callback #:913-945-5297
UMID:H06919213
TAX ID:481202402
Reference #:200993540211

Issue/Concern: Caller is calling about Claim status.

DOS: 12/05/2014
Charge Amt: $30074.94
Claim #:049476953

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim denied for 0S4 - WE ARE UNABLE TO PROCESS THIS CLAIM BECAUSE THE AUTHORIZATION NUMBER IS INVALID AND NO HMO OUTPATIENT AUTHORIZATION WAS RECEIVED MATCHING THE SERVICE(S) RENDERED ON THE DATE(S) OF SERVICE. PLEASE CONTACT THE HMO OUTPATIENT AUTHORIZATION SOURCE (E.G., MEMBER'S PCP). UPON RECEIPT OF THE AUTHORIZATION, WE WILL EXPEDITE PROCESSING OF YOUR CLAIM.

Were G and A rights given? No.
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Caller's Name:maryanne
Callback #:913-945-5297
UMID: h44137878
TAX ID:481202402
Reference #:200993540211

Issue/Concern: Caller is calling about Claim status.

DOS: 12/04/2014
Charge Amt: $27509.04
Claim #:050080184

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim is still pended and in review

Were G and A rights given? No.
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Caller's Name:carrie
Callback #:570-346-3686 ext 124
UMID:H52272976
TAX ID:232930697
Reference #:983245340711

Issue/Concern: Caller is calling about Claim status.

DOS: 09/26/2014
Charge Amt: $100.00
Claim #:018822773

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim is still pended and in review//

Were G and A rights given? No.
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Caller's Name:carrie
Callback #:570-346-3686 ext 124
UMID: h56109673
TAX ID:232930697
Reference #:983245340711


Issue/Concern: Caller is calling about Claim status.

DOS: 10/09/2014
Charge Amt: $150.00
Claim #:024753255

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim is still pended and in review//


Were G and A rights given? No.
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Caller's Name:sander
Callback #:702-939-9415
UMID:H40876992
TAX ID:251693810
Reference #:375570041311

Issue/Concern: Caller is calling about Claim status.

DOS: 05/07/2014
Charge Amt: $114745.02
Claim #:981698363
appeal- 12/10/2014

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// appeal received on 12/19/2014 still in review//

Were G and A rights given? No.
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Caller's Name:jessica
Callback #:480-488-7007
UMID:012386587
TAX ID:273836785
Reference #:248810011911

Issue/Concern: Caller is calling about Claim status.

DOS: 04/24/2014
Charge Amt: $150.00
Claim #: 201411046146421

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//

Were G and A rights given? No.
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Caller's Name:jessica
Callback #:480-488-7007
UMID:012386587
TAX ID:273836785
Reference #:248810011911

Issue/Concern: Caller is calling about Claim status.

DOS: 05/21/2014
Charge Amt: $80.00
Claim #: 201411046282011
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//

Were G and A rights given? No.
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Caller's Name:marcus
Callback #:804-399-0031
UMID:h56678520
TAX ID:541779911
Reference #:707300372511

Issue/Concern: Caller is calling about Claim status.

DOS: 05/01/2014
Charge Amt: $39312.49
Claim #:014256496

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim denied for 0gw//corrected claim requested//Attn. to Humana Correspondence Office P.O Box 14601 Lexington, KY 40512-4601.

Were G and A rights given? No.
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Caller's Name:marcus
Callback #:804-399-0031
UMID: h40672812
TAX ID: 841321373
Reference #:707300372511

Issue/Concern: Caller is calling about Claim status.

DOS: 08/11/2014
Charge Amt: $30785.14
Claim #:137958981

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim dneied for 4E - PAYMENT HAS BEEN DENIED BECAUSE YOUR REQUEST FOR AUTHORIZATION WAS NOT APPROVED. CHARGES FOR URGENT/EMERGENT SERVICE MUST BE BILLED SEPARATELY. PLEASE RE-SUBMIT ALL URGENT/EMERGENT OR APPROPRIATE OUTPATIENT CHARGES ON A SEPARATE BILL.// timely filing for appeals given// Attn to Humana Grievances and Appeals Dept. P.O. Box 14165 Lexington, KY 40512- 4165

Were G and A rights given? No.
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Caller's Name:melody
Callback #:919-372-7958
UMID:011214912
TAX ID:721604917
Reference #:063948573611

Issue/Concern: Caller is calling about Claim status.

DOS: 04/28/2014
Charge Amt: $3000
Claim #:201405016410978

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//
10:41 AM 1/7/2015- disconnected call
Were G and A rights given? No.
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Caller's Name:tanisa
Callback #:414-762-1300 ext 1460
UMID:h09857806
TAX ID:431922598
Reference #:831091344611

Issue/Concern: Caller is calling about benefit for dme//
k0800
e2207

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: 20% coinsurance// moop logged//logged elig

Were G and A rights given? No.
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Caller's Name:brandy
Callback #:903-252-6066
UMID:H49371559
TAX ID:752131429
Reference #:375038385111

Issue/Concern: Caller is calling about Claim status.

DOS: 09/04/2013
Charge Amt: $19088.00
Claim #:865544913
ref #: 374662030315
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// per ref #: 374662030315 still in process with cru//

Were G and A rights given? No.
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Caller's Name:brandy
Callback #:903-252-6066
UMID: h58820312
TAX ID: 752131429
Reference #:375038385111
Issue/Concern: Caller is calling about Claim status.

DOS: 02/17/2014
Charge Amt: $4091.00
Claim #:923145750

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// j2469 denied for 8J - THESE SERVICES REQUIRE AN APPROVED AUTHORIZATION FOR BENEFITS TO BE PAYABLE//

Were G and A rights given? No.
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Caller's Name:robina
Callback #:502-357-5564
UMID:h56796097
TAX ID:611318326


Issue/Concern: Caller is calling about Claim status.


Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: transfer to MGP: 877-691-1967

Were G and A rights given? No.
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Caller's Name:marina
Callback #:718-851-1186
UMID:H54547155
TAX ID:113351330
Reference #:473008142112

Issue/Concern: Caller is calling about Claim status.

DOS: 10/23/2014
Charge Amt: $2710.00
Claim #:047632190

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//13F - THE PRIMARY CARRIER EOB INDICATES MISSING OR INVALID INFORMATION NEEDED.

Were G and A rights given? No.
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Caller's Name:michelle
Callback #:800-543-3267 ext 15421
UMID:h48664782
TAX ID:201121194
Reference #:493471062512

Issue/Concern: Caller is calling about Claim status.

DOS: 11/01/2014
Charge Amt: $3370.00
Claim #:043711188
auth #: 068897728
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// prov was transferred to me from CIT// prov said that agent confirmed that auth #: 068897728 is valid for this claim and needs to be processed inn// send back to cru for revie.w// thank you// tat: 30-45 b.days//

Were G and A rights given? No.
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Caller's Name:lakisha
Callback #:205-392-5263 ext 2256
UMID:H49325743
TAX ID:630961535
Reference #:686285113112

Issue/Concern: Caller is calling about Claim status.

DOS: 10/17/2014
Charge Amt: $15596.00
Claim #:038096343

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim denied for 04) - PAID ACCORDING TO MEDICARE'S ALLOWABLE.//

Were G and A rights given? No.
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Caller's Name:maggie
Callback #:503-353-4155
UMID:h47349692
TAX ID:431922598
Reference #:

Issue/Concern: Caller is calling about elig and benefit for dme


Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: logged elig//
20% coinsurance// moop logged//
Were G and A rights given? No.
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Caller's Name:helen
Callback #:877-256-5371
UMID:H10589342
TAX ID:351969954
Reference #:158465223812

Issue/Concern: Caller is calling about Claim status.

DOS: 10/07/2014
Charge Amt: $1449.29
Claim #:021394830

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim summary fax to 480-606-3996 attn to brnadi mcdonald

Were G and A rights given? No.
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Caller's Name:helen
Callback #:877-256-5371
UMID: h51599218
TAX ID:351969954
Reference #:158465223812

Issue/Concern: Caller is calling about Claim status.

DOS: 08/28/2014
Charge Amt: $1436.43
Claim #:002939062

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim summary fax to 480-606-3996 attn to brnadi mcdonald

Were G and A rights given? No.
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Caller's Name:helen
Callback #:877-256-5371
UMID: h51599218
TAX ID:351969954
Reference #:158465223812

Issue/Concern: Caller is calling about Claim status.

DOS: 10/02/2014
Charge Amt: $1428.71
Claim #:019213287

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim summary fax to 480-606-3996 attn to brnadi mcdonald

Were G and A rights given? No.
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Caller's Name:helen
Callback #:877-256-5371
UMID: h44775022
TAX ID:351969954
Reference #:158465223812

Issue/Concern: Caller is calling about Claim status.

DOS: 10/23/2014
Charge Amt: $1452.49
Claim #:036437057

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//

Were G and A rights given? No.
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Caller's Name:helen
Callback #:877-256-5371
UMID: h52738013
TAX ID:351969954
Reference #:158465223812

Issue/Concern: Caller is calling about Claim status.

DOS: 11/09/2014
Charge Amt: $1396.26
Claim #:551939343

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//

Were G and A rights given? No.
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Caller's Name:helen
Callback #:877-256-5371
UMID: h59512153
TAX ID:351969954
Reference #:158465223812

Issue/Concern: Caller is calling about Claim status.

DOS: 10/14/2014
Charge Amt: $1451.52
Claim #:548320723

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//

Were G and A rights given? No.
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