PCP Change
You can search _______ to locate a provider?
Provider Online Directory
How many days does it take for an ID card to ship to member's house?
7-10 business days
During a Medical Benefits call, Members should never be transferred to ________.
Utilization Management
Where do you go to check Pharmacy Claims?
CVS CareMark under Customlinks
Can a member change their physical address with Molina?
No, Member must contact ODM or DOM
Where can we look when transactions fail at MYMolina.com
the top right-hand corner of the member's account in Salesforce.
You must verify _______ before you can send the Member's ID Card?
The Member's PCP and the Member's address
Where in Salesforce do we check Member's Eligibility?
Eligibility Check
Where do you check for Member's PA?
Managed Overrides
When completing your notes, what are the five main questions that need to be answered?
Why, What, Who, Where, When
(The Five W's)
What information must you get from the Provider on a PCP Change Call?
Are they in Network? Do they accept the insurance? Are they accepting new patients? How soon can a Member get an appointment?
Can you give Member Benefits if their account is inactive?
No
Where do you go to look up prescription names?
Drug Search on CVS Caremark
What do you do if you receive a call from a Virginia Member after you HIPAA verify?
Warm transfer to a Virginia Rep
What do you click on when you want to search for additional criteria in a PCP Change?
Advanced Search
Can a minor order an ID card?
No
How many legs does a member use to go from their home to the doctor's office?
1 leg
What list can a member and a doctor review prior to prescribing a medication?
The preferred list
Where do you go to update a Member's language?
Primary language dropdown
Grandma called in to do PCP Change for grandchild who is over 17 can we complete the change with verbal consent dated July 16 2022
No she can't
Can employees look up their benefit information?
NOPE!!!!!!!
What is the processing time to complete a pharmacy PA?
24 hrs
Can a representative with verbal consent do a Demographic Change?
No