Rx
What is the purpose of Rx Nova (argus)
To ensure we are giving correct copay amounts when running test claims AND complete overrides!
What is the name of the app members can use to view almost all info regarding their plan?
MyHumana.com OR the MyHumana App!
Member is needing to refill her gabapentin through centerwell pharmacy, can we do this?
YES! Go to the mail order link in crm to complete this!
If a member has the OTC benefit with Centerwell Pharmacy ONLY, can they use it at walmart as well?
NO!
TRUE or FALSE: You never need to use mentor
FALSE, use it on every call! :)
What is the purpose of RxConnect Pro?
View Rx Stages, View correct quantity / day supply limits, View benefit grid, AND View order summaries!
What system allows us to walk members through there MyHumana?
Web Emulation 2.0 from HI page
Member is needing to update her mailing address through centerwell pharmacy, can we do this?
YES! Click the Mail Order Pharmacy tab in crm!
If a member has $50 left on her OTC benefit, but the order total is $60, what can we do?
Offer to take things off the order OR have the member pay the remaining balance!
TRUE or FALSE: You can update an OON PCP
FALSE! we can ONLY update INN PCPs, dr will need to reach out to provider relations dep!
Member wants to know her copay for Eliquis 5mg, what system is needed for this?
RxNova (ARGUS)
TRUE or FALSE: We are allowed to give our members usernames for MyHumana!
FALSE!
Member is needing to delete an rx off her account, can we do this?
NO! WT to Centerwell Pharmacy!
What system is used to place OTC Orders?
DIGBOT
What is the goal for ACW / HOLD?
ACW- 30sec
HOLD- 60sec
(end goal is 0)
Member wants to know what RxStage she is in, what system is needed for this?
RxConnect Pro!
Once you open the Web Emulation 2.0, what tab at the top must we choose?
MyHumana tab!
TRUE! It saves $$$ and is easier for our members, they don't even have to leave home to get there rx!
What is the system we use to send OTC Catalogs?
EMME
TRUE or False: We never need to read members the guidance alerts!
FALSE! we ALWAYS read it off to the members, just read it in your own words immediately after verifying phone #!
Member got a letter saying she was approved for LIS, where can we check this?
CRM, DEBUT, and CI!
If we don't have the members AKA name, how can we find it?
Click Lookup AkaName on the right, then enter mbr id, dob, & first and last name!
RxConnect Pro Order Summary link is down, where else can we check the status of an order?
Mail Order Pharmacy tab link at the top of CRM!
What is the GO link for OTC Catalog?
go/otc
What is the purpose of using mentor?
To make sure we are giving not only correct info, but also giving up to date info as well. Insurance and Policys are always changing, we want to ensure we are giving the 100% facts to our members!