RxHD Benefits Link
RxHD Tabs
Claim and Product Information
Documentation
Misc
100
The ribbon where you can locate the copays for medications.
What is Copay Tiers?
100
The default tab displayed when you pull up a member's account.
What is Member Claim History?
100
The hyperlink you click on to view the claim information.
What is Rx #?
100
In order to save documentation, this is the first step you must take.
What is Click the ACVD Button?
100
A request submitted to an insurance company for payment.
What is a Claim?
200
The ribbon where you can locate which formulary to use.
What is Formulary Information?
200
The tab you can use to locate if a member has an alternate insurance.
What is Member Demographics? or Benefit Accumulators?
200
The link you click on to locate the Product Information.
What is the NDC #?
200
Where you can view notes regarding Prior Authorizations.
What is Member Notes?
200
4 examples of PHI
What is Name, DOB, Address, Member ID, Phone #, Email address?
300
The ribbon where you can locate BIN, PCN, and Group #.
What is Processing Information?
300
The tab where you can locate an address for the member's Appeals and Grievances.
What is Plan Contacts?
300
The link you use to view the medi-span information.
What is the GPI Link?
300
What you should do if you enter notes in the wrong member's accout.
What is create another separate note specifying to disregard previous note as it was meant for another account?
300
2 types of calls when authentication is not required.
What is when they are calling for phone numbers or fax numbers, requests for Authorized Representative Form, filing a privacy complaint, requests for a copy of the Notice of Privacy Practice, requests for Privacy Office contact information, or requests for hours of operation?
400
The ribbon where you can locate how many day supply the member can get at a retail pharmacy or at mail service.
What is Copay Tiers?
400
The tab where you can locate if a member has met their deductible.
What is Benefit Accumulators?
400
The column you use if a member is questioning the price of a medication.
What is the Client column?
400
The 6 'Caller' options listed and which is the default?
What is Member, Pharmacy, Internal Rep, Plan, Physician, and Other? Pharmacy is the default
400
A limitation or condition for coverage on a medication.
What is an Edit?
500
The ribbon where you can locate if a vacation supply is allowed.
What is List of Available Overrides?
500
The tab that you access to update a member's eligibility.
What is Member Demographics?
500
Three reasons an NDC # may be inactive.
What is because a drug manufacturer is no longer in business, a medication has been discontinued and is replaced with a newer one, or the FDA has issued a recall on a medication?
500
The 4 pieces of information you must document for every call.
What is who you spoke with, what was requested, how you resolved the issue, and your response to the caller?
500
Three reasons a claim might reject.
What is because of claim transmission errors, the prescription has been refilled too soon, or plan limitations are exceeded?
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