Order Placement
Order Status
Test Claim
Hipaa
Misc.
100
CCRs will offer this whenever a prescriber needs to call in a new prescription, and for certain scenarios in which a member needs a new prescription.
What is Faststart.
100
_____is a term used when an order has been received and is being held, and will be released on a future date.
What is Future Fill
100
This allows the CCR to modify the quantity, day supply and other information for a test claim, without having to clear the screen and start from the beginning.
What is Edit Drug Button
100
CCR's must verify these to authenticate a members account.
What is 3 authenicators (at least 1 primary)
100
A Client Information Form (CIF) can be accessed by performing a search in CareSource or via hyperlink from PeopleSafe. (True or False?)
What is True
200
You have to read this to the member every time you place a refill.
What is the Disclaimer
200
CCR's will do this when a member would like to bulk up their RX from 30 days to 90 days supply at mail order.
What is Courtesy Retranslation RM Task
200
This is the work instruction that you use for packaged medications test claims
What is Test Claim: Calculating Quantity of Package Medication
200
You must ask this to 3rd party callers (i.e this is not needed for doctors offices or pharmacies)
What is 3rd party question "Is the member aware that you are calling on their behalf?"
200
________ are requests for a benefit that was partially or completely denied which could be for a drug that is not covered by a plan, for a denied Prior Authorization or for when some Plan Benefit Override requests are not allowed by the client.
What are Appeals
300
CCR's will use this to check the status of a prescription refill before the order information appears on the Main Screen
What is Refill Status
300
CCR's cannot make changes to an mail order once it reaches this stage.
What is Label Ready, Metered or Packed
300
These explain to you why a medications is denied. (i.e under the detail screen)
What is the Settlement Codes
300
CCR's may provide the members ID to the member only after doing this.
What is verifying the HICN number on the account.
300
If applicable to the plan, indicate which tab in PeopleSafe you would select to view how much has accumulated toward the MOOP/OOP, MAB, or deductible.
What is the Account Balance Tab
400
This capability is intended as a temporary solution in selected situations to gap a need for medication until an existing prescription (Rx) arrives.
What is Bridge Supply
400
CCR's cannot select 2 day or next day shipping if the member has this as the shipping address.
What is a P.O Box
400
CCR's must read this every time that they run a test claim.
What is the Disclaimer
400
The member must have this sent in and placed on their account before we can make changes on the account for a 3rd party.
What is Power of Attorney POA
400
To identify general co-pay/coinsurance information for a member’s plan in Peoplesafe, you should access the _____________________________________ Tab
What is Plan Summary
500
CCR's will create a this when a systems error does not allow a refill to be placed using normal processes.
What is Manual Refill RM Task
500
CCR's must always click this once they have made any changes to a mail order.
What is the Update Button
500
!!Daily Double!! This code must be used when the Prescriber has indicated, in a manner specified by applicable law, that generic substitution is permitted and the brand product is dispensed when a currently marketed generic is not stocked in the Pharmacy.
What is DAW 4 Substitution Allowed - Generic Drug Not In Stock
500
CCR's must get these 2 things when speaking to a pharmacist on a members account.
What is the NPI number & Caller’s name
500
This is the system that you will use to file Grievances for the members
What is Medhok
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