ESD
MEDICARE
KNOWLEDGE BLAST
ESAWS
RIDDLE ME THIS
100
This is where you can find the patient's address and phone number
What is the Eligibility screen
100
LIST 3 MEDICARE PREFERRED PHARMACIES
WALGREENS, RITE AID, DUANE READE, ACPNY
100
What HIPAA do you verify with member?
ID or SSN, name, dob, address
100
These are the inquiry types you can pull up in ESAWS (name 2)
What is member, provider, broker, unlisted, service request
100
What has a head, a tail, is brown, and has no legs?
What is a penny
200
How many fills can a member get at retail for members under Select home delivery
2 fills
200
These 2 groups does not have a coverage gap
What is the 1199 and LIS group
200
Name at least 4 that cannot be discussed with a parent about a Medicaid minor
Family planning, STD, HIV, Misuse of substance, pregnancy and childbirth, Mental health
200
This transaction means that a member is "staged"
What is transaction 50
200
What is easy to get into, but hard to get out of?
Trouble
300
This is what you would do if a pharmacy is getting a rejection code "MR" (non formulary)
Advise to have doctor submit a PA
300
What does the abbreviation (EPIC) mean
Elderly Pharmaceutical Insurance Coverage
300
This is where the list of formularies can be found
What is Sharepoint, G-drive, emblemhealth.com, ESAWS
300
This is were you will find the plans that member previously had
What is membership history tab
300
You see a boat filled with people. You look again, but this time you don't see a single person on the boat. Why? Hint: The boat has not sunk
All the people on the boat are married
400
Refill too soon can be done with in this timeframe
WITHIN 7 DAYS OR LESS PRIOR TO THE NEXT REFILL
400
What is the amount for the ICL, coverage gap, catastrophic phase
$3700 ICL, $4950 coverage gap, 5% catastrophic
400
What group has mandatory or select home delivery?
What is the City of NY
400
This is where you can find the formularies without accessing a member's account in ESAWS
What is the 'REFERENCE' TAB
400
You can see me in water, but I never get wet. What am I?
What is a reflection
500
In which section In the drug coverage, will you find information on a particular drug in regards to quantity, prior authorization requirements, and step therapy, etc.
coverage notes
500
These members have a $330 deductible
VIP ESSENTIAL AND VIP VALUE
500
The steps to get to QCARE
ENET>>TOOLS AND RESOURCES>>MORE>>HOST ON DEMAND (HOD)
500
When we enter a grievance & appeals SR request. This is the department we "REFER" them to
What is the "PHARMACY"
500
I go in hard. I come out soft. You blow me hard. What am I?
What is a gum
M
e
n
u