NUANCES
How many nuances guides are there?
3
What symbol do you need click often in intake to look up provider, code field, and diagnosis?
Magnifying Glass
What code can be used as a placeholder if the provider doesn't write what medication they are requesting.
J3490 - Unclassified Drugs
Would we update? If yes, please convert to EST/Military time.
LOB: CA Medicaid
Received by Centene 2025-05-12 11:57:00.000 PST
YES.
05/12/2025 14:57
Who hosted the 2012 Summer Olympics?
London
LOB: WA Exchange
We receive an inpatient request, who would work this request?
Redirect to UM (PHCO) team: Fax number 833-828-0215
What resource can you use to determine if the manual received time needs to be updated?
Updating Manual Received Date/Time Flowchart
What LOB requires a signature on the request from the provider to be considered expedited?
TX Medicaid
Would we update? If yes, please convert to EST/Military time.
LOB: FL Exchange
Received by Centene: 2025-05-12 15:32:00.000 CST
YES.
05/12/2025 16:32
Actor Steve Carell plays Michael Scott in what popular TV series?
The Office
LOB: OR MEDICARE
What department is responsible for code E0776?
Redirect to UM (PHCO) team: Fax number 833-828-0215
You receive a diagnosis of E113513
Where does the . need to go?
E11.3515
What is the intake mode for NCH/Evolent fax
Facsimile-Evolent
Would we update? If yes, please convert to EST/Military time.
LOB: CA Medicaid
Received by Centene 2025-05-12 11:57:00.000 PST
YES.
05/12/2025 14:57
What planet is closest to the Sun?
Mercury
LOB: FL EXCHANGE
You receive a request for Synagis (HCPCS code 90378) who reviews this request?
ONLY reviewed by the Medpharm Team. Do NOT route to Retail Compass Pharmacy Team.
What LOBs use Units instead of Visits?
What would we do with a Pharmacy Benefit request for NY-Medicaid-Fidelis (Plan codes: 10032, 10027, 10028)
Fax the request back to the requestor.
Add note: Please forward these pharmacy requests to State of New York Medicaid, as those requests are carved out by the state.
Would we update? If yes, please convert to EST/Military time.
LOB: TX Medicare. Priority is EXPEDITED.
Received by Centene 2025-05-15 07:32:00.000 EST
NO
Do not update the manual received date/time for Medicare Expedited requests
How many reindeer does Santa have?
Eight
LOB: OK Medicaid
You have a request for a home infusion medication, this case would be built by medpharm team?
No.
Send to Retail Pharmacy (Compass) for home infusion medications: Fax 844-235-5092
You receive a 75 page request that is only clinicals with member name/dob at top of each page. Can we build this request?
Yes, if we are able to locate the member's profile we are required to build a case for it.
LOB: NY Exchange
We receive a request for J0586 for Dysport with codes 95873, 95874. Who would review these procedure codes?
Request does not need to be forwarded to the medical department. The CPT will be reviewed along with the medication
Would we update? If yes, please convert to EST/Military time.
LOB: NY Medicaid - NCH/Evolent CTR Form
Date: 05/12/2025 03:22 PM PST
All cases received from NCH/Evolent must have the Manual Timestamp updated and converted to EST in the COMPASS system.
05/12/2025 18:22
Which singer’s real name is Robyn Fenty?
Rihanna