N DRUG/Compounds
Group Profile
Authorization procedures
BONUS
100
Answer- Oklahoma, Tennessee and Texas
Which states follow the N Drug rules?
100
American Claims Management # 2900
What group requires all auths to be checked prior to sending?
100
This program helps determine who the ADJ is for Amerisys/PGCS and USIS claims.
What is CORRUS?
100
25% or less is our team goal
What is the expired auth percentage for our team?
200
Old law applies – N Drugs do not apply
What are TPCIGA claims prior to 1991 considered?
200
Steadfast Insurance Company and Nez Perce Tribe
What is the name of payers under ACM with specific group instructions?
200
This group uses terms like Enhanced UR/Non Enhanced
What is Broadspire?
200
This document is located in the Z drive and contains the list of ADJ that no longer work for their perspective companies.
What is the NLE list?
300
Jeanette Jackson, Lucy Rivas, Anthony Villa, SMEs and Triage team
Who are the members of the TPCIGA Task force?
300
Cecilia Spada
Who is the ADJ that we send narcotics to for ACM #2900
300
I like for my first follow up to be two hours, regardless of the day or time.
What is Cincinnati Insurance?
400
Reasonable and Necessary
What term does a TEXAS ADJ use when expressing that a medication is not approved?
400
This group requires outlook emails to be sent to IMO UR on ALL N Drug rejections
What is SORM?
400
For this group, I have to check the funding on the claims tab prior to processing
What is Rising Medical # 6003
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