Notes

Caller's Name:DEBBIE
Callback #:843-777-4433
UMID:H55004351
TAX ID:570370242
Reference #:519990500309

Issue/Concern: Caller is calling about Claim status.

DOS: 08/02/2014
Charge Amt: $220
Claim #:995838575

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim summary faxed to 843-777-4433 attn to debbie// tat: 48-72 hrs.

Were G and A rights given? No.
01
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Caller's Name:shannon
Callback #: 561-862-1640 ext 1736
UMID:H46408636
TAX ID:560543238
Reference #:688557291009

Issue/Concern: Caller is calling about Claim status.

DOS: 03/04/2014
Charge Amt: $2208.02
Claim #:972606715

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//Attn. to Humana Claims Office P.O Box 14601 Lexington, KY 40512-4601.// Attn to Humana Grievances and Appeals Dept. P.O. Box 14165 Lexington, KY 40512- 4165// timely filing given//

Were G and A rights given? No.
02
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Caller's Name:emily
Callback #:866-440-6320 ext 6451
UMID:h4237251900
TAX ID:742781812
Reference #:320107042809

Issue/Concern: Caller is calling about Claim status.

DOS: 12/23/2012
Charge Amt: $326331.70
Claim #:849885841

Expected Outcome:To provide accurate information.

Systems used: GCP

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

Were G and A rights given? No.
03
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Caller's Name:shiela
Callback #:717-972-1368
UMID:012846603
TAX ID:251813126
Reference #:701081173909

Issue/Concern: Caller is calling about Claim status.

DOS: 07/07/2014
Charge Amt: $22857.50
Claim #:201408053933244
appeal- 11/10/2014
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// medical records needed//

Were G and A rights given? No.
04
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Caller's Name:kelly
Callback #:906-341-3225
UMID:H53528242
TAX ID:742517055
Reference #:978701284609

Issue/Concern: Caller is calling about Claim status.

DOS: 04/21/2014
Charge Amt: $5534.50
Claim #:950846947
ref #: 600443005208
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// still in process// follow- up request to Supervisor//

Were G and A rights given? No.
05 (FOLLOW- UP)
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Caller's Name:andrea
Callback #:352-746-0077 ext 2
UMID:h47348384
TAX ID:593055043
Reference #:347468435209

Issue/Concern: Caller is calling about Claim status.

DOS: 12/30/2014
Charge Amt: $108.00
Claim #:056200473

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// on line 11057 prov disputing the member's reponsibility there should be $30 copay// pls review thank you//
Were G and A rights given? No.
06
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Caller's Name:sue
Callback #:716-692-2160 ext 357
UMID:H49720817
TAX ID:300012904
Reference #:237702260010

Issue/Concern: Caller is calling about Claim status.

DOS: 09/04/2014
Charge Amt: $660.00
Claim #:041247135
ref #: 111211351608
Expected Outcome:To provide accurate information.

Systems used: GCP

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

Were G and A rights given? No.
07
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Caller's Name:sue
Callback #:716-692-2160 ext 357
UMID:H49720817
TAX ID:300012904
Reference #:237702260010

Issue/Concern: Caller is calling about Claim status.

DOS: 09/22/2014
Charge Amt: $610.00
Claim #:023548383

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim summary faxed to 716-213-0105 attn sue


Were G and A rights given? No.
08
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Caller's Name:sue
Callback #:716-692-2160 ext 357
UMID:H59690917
TAX ID:300012904
Reference #:237702260010

Issue/Concern: Caller is calling about Claim status.

DOS:01/22/2014
Charge Amt: $865.00
Claim #:920910807

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim summary faxed to 716-213-0105 attn sue//

Were G and A rights given? No.
09
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Caller's Name:sue
Callback #:716-692-2160 ext 357
UMID:H49720817
TAX ID:300012904
Reference #:237702260010

Issue/Concern: Caller is calling about Claim status.

DOS: 10/20/2014
Charge Amt: $ 150.00
Claim #:027614635

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim summary faxed to 716-213-0105 attn sue//

Were G and A rights given? No.
10
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Caller's Name:sue
Callback #:716-692-2160 ext 357
UMID:H40703276
TAX ID:300012904
Reference #:237702260010

Issue/Concern: Caller is calling about Claim status.

DOS: 11/25/2013
Charge Amt: $16710.00
Claim #:893119814

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//claim summary faxed to 716-213-0105 attn sue//

Were G and A rights given? No.
11
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Caller's Name:virginia
Callback #:801-587-6952
UMID:H42599300
TAX ID:876000525
Reference #:453180262510

Issue/Concern: Caller is calling about benefit for sleep study - op hosp

95811

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken:$100 copay// moop logged
// auth not required//
Were G and A rights given? No.
12
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Caller's Name:keisha
Callback #:601-354-4488 ext 212
UMID:H55906829
TAX ID:640699768
Reference #:355392243010

Issue/Concern: Caller is calling about auth.

72148

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: auth is required//

Were G and A rights given? No.
13
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Caller's Name:michelle
Callback #:9319671160
UMID:h52938962
TAX ID:1922388297
Reference #:814893243610

Issue/Concern: Caller is calling about Claim status.

DOS: 12/28/2013

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim not on file//

Were G and A rights given? No.
14
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Caller's Name:amanda
Callback #:6027783084
UMID:H51571466
TAX ID:721404705
Reference #:320237493910

Issue/Concern: Caller is calling about appeals address.

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken:Attn to Humana Grievances and Appeals Dept. P.O. Box 14165 Lexington, KY 40512- 4165

Were G and A rights given? No.
15
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Caller's Name:jenny
Callback #:336-378-1110 ext 106
UMID:H53468797
TAX ID:163950647
Reference #:956405284310

Issue/Concern: Caller is calling about Claim status.

DOS: 05/20/2014
Charge Amt: $2130.00
Claim #:970141930
ref #: 873978490210

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// CIT: 800-523-0023// PROV will make sure if auth is required and if auth is valid for claim//

Were G and A rights given? No.
16
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Caller's Name:roman
Callback #:8552770320
UMID:h43024731
TAX ID:351183155
Reference #:109264375210

Issue/Concern: Caller is calling about Claim status.

DOS: 05/01/2014
Charge Amt: $1136.00
Claim #:979133187

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim denied for no referral//Attn. to Humana Correspondence Office P.O Box 14601 Lexington, KY 40512-4601.


Were G and A rights given? No.
17
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Caller's Name:roman
Callback #:8552770320
UMID: h49769382
TAX ID:351183155
Reference #:109264375210

Issue/Concern: Caller is calling about Claim status.

DOS: 09/05/2014
Charge Amt: $156.00
Claim #:543136249

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim denied for 09f, 097 and 0wn.

Were G and A rights given? No.
18
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Caller's Name:roman
Callback #:8552770320
UMID: h58780910
TAX ID: 351183155
Reference #:109264375210

Issue/Concern: Caller is calling about Claim status.

DOS: 04/15/2014
Charge Amt: $293.00
Claim #:970015844

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// check #: 001290019091507// fax claim summary to 866-770-4955 attn roman//

Were G and A rights given? No.
19
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Caller's Name:roman
Callback #:8552770320
UMID: h44672033
TAX ID: 351183155
Reference #:109264375210

Issue/Concern: Caller is calling about Claim status.

DOS: 02/14/2014
Charge Amt: $57.00
Claim #:982117878

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// denied for no referral//

Were G and A rights given? No.
20
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Caller's Name:ceclilah
Callback #:208-528-7566 ext 1007
UMID:h55003416
TAX ID:820526792
Reference #:738543491111

Issue/Concern: Caller is calling about Claim status.

DOS: 01/14/2014
Charge Amt: $1048.00
Claim #:004995537
000589766
Expected Outcome:To provide accurate information.

Systems used: GCP

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

Were G and A rights given? No.
21
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Caller's Name:ceclilah
Callback #:208-528-7566 ext 1007
UMID:h55003416
TAX ID:820526792
Reference #:738543491111

Issue/Concern: Caller is calling about Claim status.

DOS: 02/14/2014
Charge Amt: $1084.00
Claim #:004995336
09/22/2014
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//0~A - THE PROVIDER HAS NOT SUBMITTED REQUIRED INFORMATION FOR THIS SERVICE. YOUR PROVIDER HAS BEEN ASKED TO RESUBMIT THE CLAIM//

Were G and A rights given? No.
22
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Caller's Name:billy
Callback #:8172763304
UMID:H46414486
TAX ID:752131429
Reference #:908969403111

Issue/Concern: Caller is calling about Claim status.

DOS: 11/20/2014
Charge Amt: $1158.00
Claim #:141866897

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//09 - THIS CLAIM CONTAINS AN EXCESS NUMBER OF UNITS FOR THE DRUG BILLED BASED ON THE DIAGNOSIS SUBMITTED//

Were G and A rights given? No.
23
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Caller's Name:holly
Callback #:940-380-7125
UMID:H53302876
TAX ID:271365684
Reference #:496042553511

Issue/Concern: Caller is calling about Claim status.

DOS: 05/19/2014
Charge Amt: $32250.00
Claim #: 134698629
ref #: 019345421317
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// claim is pending for high dollar amount//

Were G and A rights given? No.
24

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Caller's Name:sheryl
Callback #:804-458-2300
UMID:h54471988
TAX ID:541874728
Reference #:252322514111

Issue/Concern: Caller is calling about Claim status.

DOS: 08/26/2014
Charge Amt: $109.00
Claim #:002820128
medical rec- 11/05/2014

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// prov disputing about 08/26/2014 claim #: 023403653 99239 // should be paid medically because member was seen by the docotr beofre being enrolled in hospice.
10:58 AM 1/6/2015- call got disconnected
Were G and A rights given? No.
25
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Caller's Name:thelma
Callback #:918-599-4520
UMID:H42639011
TAX ID:264331175
Reference #:573501511712

Issue/Concern: Caller is calling about Claim status.

DOS: 06/07/2013
Charge Amt: $55459.86
Claim #:040410834

Expected Outcome:To provide accurate information.

Systems used: GCP

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

Were G and A rights given? No.
26
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Caller's Name:gwenda
Callback #:903-606-7096
UMID:H46278162
TAX ID:750818167
Reference #:358447202112

Issue/Concern: Caller is calling about Claim status.

DOS: 10/22/2014
Charge Amt: $23048.50
Claim #:140937430
auth #: 068491674
Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given//24H - PAYMENT HAS BEEN DENIED BECAUSE YOU FAILED TO REQUEST AN AUTHORIZATION. CHARGES FOR URGENT/EMERGENT SERVICES MUST BE BILLED SEPARATELY. PLEASE RE-SUBMIT ALL URGENT/EMERGENT CHARGES ON A SEPARATE BILL. YOU MAY SUBMIT MEDICAL RECORDS FOR FURTHER REVIEW// transfer to CIT: 800-523-0023

Were G and A rights given? No.
27
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Caller's Name:jodi
Callback #:605-444-8206
UMID:H30075221
TAX ID:841505075
Reference #:304977432712

Issue/Concern: Caller is calling about Claim status.

DOS: 10/02/2014
Charge Amt: $4965.00
Claim #:020544354

Expected Outcome:To provide accurate information.

Systems used: GCP

Actions Taken: claim logged// claim info given// prov disputing 66984// allowed at 0 and no exp code//
per cis pro allowed at $939.97// send back to CRU: pls. reviw thank you.

Were G and A rights given? No.
28
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Caller's Name:CHRISTINE
Callback #:978-922-3080 EXT 362
UMID:H58181229
TAX ID:462540965
Reference #:690734583612

Issue/Concern: Caller is calling about Claim status.

DOS: 06/26/2014
Charge Amt: $10055.64
Claim #:555010644

Expected Outcome:To provide accurate information.

Systems used: GCP

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

Were G and A rights given? No.
29
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Caller's Name:CHRISTINE
Callback #:978-922-3080 EXT 362
UMID:H58181229
TAX ID:462540965
Reference #:690734583612

Issue/Concern: Caller is calling about Claim status.

DOS: 07/02/2014
Charge Amt: $43574.44
Claim #:555010645

Expected Outcome:To provide accurate information.

Systems used: GCP

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

Were G and A rights given? No.
30