what ribbon in the benefit links do you choose to see if a member has a split tier deductible/ special deductible?
accumalators
100
At what age does a child need to give authorization for a parent to speak with us?
13
100
What does RAF stand for
release action form
100
4 Preferred method of payments in orders?
cc, ach, mail in check, s/b
100
How do members contact the privacy office?
PHONE AND ADDRESS
200
On Optumrx.com, an incomplete home delivery account will block online registration. A home delivery account must have 3 things for a successful online registration to occur.
Bill to/ Ship to address, Account Number,Active Coverage
200
Besides name and DOB, which of the following can be authenticated?
PHONE #, ZIP
200
What is used as a wildcards in iris?
% and _
200
Why would a member get a med without the other in a order?
number indicated by shipset are different in order
200
What 3 forms are available on the Manual Orders SharePoint site?
Manual IRIS Updates
Refill order
Entry PSC manual order
300
in RxHd what do you have to press first to see if a member has a prior authorization on file?
refresh button beside add member notes button
300
If a customer has more than one account, and each is active with different mail service accounts numbers, what steps do you take to have both accounts merged into one?
Open the EBC in the primary account and create a DE Merge Patient Account Merge Task.
300
How do you find out the payment method that was used in an order?
click order payments under order summary
300
Calls to pay his bill, what is end interaction?
ACCOUNTING
300
Mr. Watson has past due balance for multiple order how will he make a payment?
payment to account
400
what form in the manual order sharepoint do you use for tax purposes?
Rx History form
400
When should you quote eta dates?
quote eta dates for every order you place and/research for a member
400
To submit a request for a Proactive Script Capture (PSC), the member must be
able to verify the _____________ of the medication, in addition to the doctor’s
information. (4 things)
Name, strength, dosage form, and quantity
400
You notice the Past due balance is higher than the total open receivables, what task should you choose to get that updated?
accounting update AR
400
Call flow steps?
greeting, authenticate, update account, address concerns, address alerts, close
500
in RXhd where do you go to see the amount that was paid back to the pharmacy in a claim?
select claim-> payment history-> amount paid
500
When registering in optumrx.com and email is sent what does it contain?
confirm email address link and confirmation code to copy and enter in browser
500
what are the three common reasons for copay changes?
1. Total cost of medication has changed
2. Claim may have process differently from last time
3. Medication could have changed to another tier
500
Member called in to order rx, not avail until next Tuesday. She has 2 rx's available now. None of the rx's are controlled. What should you do?
offer to place the future dated order for all 3 rx's for next Tuesday (TST)
500
On the Price Check form in IRIS, the DAW field defaults to _____.