Maestro
Intent that is used in Maestro for provider search
What is Search and Assign Provider?
System used to submit, cancel, and verify status of Coverage Determination
What is PAS (Prior Authorization System)?
The DA we miss but are happy for!
Who is Dani!
Medicare eligibility source of truth
What is Marx?
Under the Summary page in Maestro, it shows the type of Medicaid and Medicaid History for a member
What is the Healthcare Plan section?
Covered Medications are organized into _______.
Tiers
This person stated" Yall better help me or I am fighting"
Who is Jacquelyn Nguyen?
Order replacement OTC cards, OTC balance and fulfillment settings
What is Solutran?
Request type that is selected under the Members Materials intent to send a provider directory
What is Perform Materials Fulfillment?
There may be effective, lower-cost drugs that treat the same medical condition as this drug. The member may be required to try one or more of these other drugs before the plan will cover the drug.
What is Step Therapy?
This person suggested Kahoots to break up the monotony.
Who is Mickey?
Used to get Renew Active code and gym locations
What is Renew Active Admin Portal?
Intent uses to find benefits for Tobacco Cessation
What is Review Medical Benefits?
Made at the direction of your plan after careful clinical review by doctors and pharmacists.
Formulary Changes
Candy Eddy never heard of until this class
What is Sugar Babies/Sugar Daddy?
View Medicare and Medicaid Plan details by state
What is UHC Community Plan Website?
This intent provides Advocates with a direct link to the Formulary Lookup tool
What is The Formulary Lookup intent?
Amount of time member has to file an appeal from the date of a PA Denial Notice for a medication.
what is 60 days?
Samantha Moore's birthday.
What is March 3rd?
Tool used to view OTC Only, Healthy Food Only, and OTC + Healthy Food programs provided through Solutran.
What is Solutran Portal?