Claims, Clicks & Chaos
New hires log in to CCA with this number and a password on the CVS Health single sign-on screen.
What is a DEVH number?
GNA, the date that drives urgent refill decisions, stands for these three words.
What is Guaranteed Next Appointment?
Pharmacy Guides don't assess severity or diagnose conditions, and they never provide this.
What is medical advice?
To bookmark your schedule page, you go to Admin > Meridian > this.
What is User Schedule?
This category is worth 10% and measures reliability, attendance, and adherence.
What is Team Commitment?
This is the primary way to search for a member in CCA.
What is the Plan Member ID?
If a member has no refills remaining on file, you connect them to this team.
What is Enhanced Direct Care (EDC)?
Besides chest pain, trouble breathing, swelling of the face/lips/throat, severe rash/hives/itching, and bleeding or unusual bruising, guides screen for this.
What is severe pain?
This is the broadest grouping in the workforce hierarchy, with Grievances & CTM as an example.
What is a Workforce Area?
QCM, the basis for the Member Experience & Quality score, stands for this.
What is Quality Call Monitoring?
Clicking the member's name hyperlink in the search results opens this page, which shows plan details, carrier name, and status.
What is the eligibility page?
Fewer than this many days until the GNA, with AHS unlikely to request the refill in time, means connecting the member directly to their provider.
What is 10 days?
Seizures lasting longer than this many minutes stop the normal workflow and trigger emergency protocols.
What is 5 minutes?
This is a guide's home team, which determines pay grade and supervisor.
What is a Workforce Function?
Logging into TalkDesk more than this many minutes late counts as Late-to-Ready.
What is 2 minutes?
To refill a maintenance medication through CVSMO, you find it under Prescription Info and select this under Refill Options.
What is Start Mail Service?
If an EDC appointment is scheduled less than an hour from the scheduling window, you do this in the channel.
What is notify the Nurse Practitioner?
In TalkDesk, you select this option and choose care-pathway-guide-english or care-pathway-guide-spanish.
What is Consult?
To edit or delete approved PTO through #Guide-WFM-Communication, you must ask at least this many hours in advance.
What is 12 hours?
The "Golden Trio" is Extended Days Supply with multiple refills, Autorefill/MOT, and this.
What is Home Delivery?
To simulate a claim, you select this under Select Claim Options, then click this button to see results such as a "Refill Too Soon" reject.
What are Test Claim and Run Test Claim?
When the GNA is less than 2 days away, you escalate in this Slack channel and tag this group.
What are #every-day-care-coordination and @everydaycare-np?
For an urgent escalation, you choose this Call Category in Note-Taking, and you never manually create these.
What are Request / Clinical Guide Transfers and cases?
Self-service flex time and overtime requests are automatically approved under this condition.
What is being assigned to the corresponding activity?
In Q4, Member Impact is unweighted on the Looker scorecard, but it still determines this.
What is whether quarterly bonuses pay at "Meets" or "Exceeds"?