NAVITUS SYSTEMS
The system PA Agents use to complete E-Learnings and corporate classes.
What is Cornerstone/PAL's
Predetermined criteria a member must meet for a request to be approved to allow the drug to be covered for the member.
Prior Authorization
What Internet Browser do we use for Banjo?
What is Chrome?
What is the name of the screen where we can learn information on medications?
What is the Drug Screen
this is the type of drug that shows up on the formulary in all CAPITAL LETTERS.
What is a Brand Drug.
The system PA agents use to view their schedule.
What is Aspect
The people who determine what criteria would justify coverage of the drug and make recommendations for drug placement on the formulary.
Who is the P&T Committee
What are the two different log-in versions for the Banjo Environments?
What is Navitus-UAT and Navitus
The screen used to view the member's name, DOB, demographics.
What is the Member Screen. CTRL + M.
What are the three resources we can use to review the formulary?
What is Formulary through Launch House, FPOS through lighthouse, and RXFLEX?
The system PA Agents use to clock in and out of each day at the start of their shift, lunch, and end of the day.
What is ADP
A list of drugs that limits the number of drugs available within a therapeutic class for purchasing, dispensing, and/or reimbursement. Each is uniquely tailored to the client's needs.
What is a formulary
What are the four most commonly used icons we will select from in the Menu Bar?
What is Home, Tasks, Patients, Documentation?
The screen that houses information relating to Prescribers and their NPI (National Provider Identifier) and DEA (Drug Enforcment Agency) numbers.
What is the Prescriber Screen.
What are 3 UCare plans we work with?
Daily Double! Points will be doubled for this question if you can identify which is Medicaid and which is Exchange
Medicaid: NVMNCA, NVMSCP, NVPMAP, NVUCCO
Exchange: NVMNOFF, XNVMNON
This system homes the CCG - specific client information, Patient Pay amounts and much more.
What is Lighthouse
The group of drugs used to treat the same illness or medical condition. Example: ADHD, Diabetic, Antidepressant, Cardiovascular
What is a Therapeutic Class
What are the three queues that we will work in from the Queue Selection?
What is Intake FP, Outreach RFI Fax, and Processing FP?
The button you must click if you fill in any boxes that are blue.
What is Seek on Blue
This is the FDA equivalency code indicating a generic is interchangeable with pharmaceutically equivalent brand name products.
What is an A Rated Drug.
The system that combines most of our resources into one. It will tell us if we process the clients PA's, NCQA Accredited, Formulary and Tier levels, PA Requirements, TAT times, drug specific documents, one off situations, FAQ's, MPA References, etc.
What is Launch House
The generic drug has the same amount of an active ingredients delivered to the body at the same time and the active ingredients must be used by the body in the same way as the brand drug.
What is a Bioequivalent drug?
What is the name of the screen where we can see patient information including PHI, and previously worked cases.
What is the Member Screen?
The 3 filters you must drag when searching for a specific drug.
What is Drug Name, Discontinued, RepackCode.
What are the 5 request types that will be processed on an Exception to Coverage (ETC) Decision Tree
What is Not Covered(NC), New/Not Reviewed Drug (ND/NR), Quantity Limit (QL), Gender Specific, High Dose(HD)?