Say Si If You See A "C"
Word! (or not)
Return to Sender
No One Reads Their Emails
Don't Shun the Function Key Fun
100
Talk about high maintenance! If you run into an ROA PA for this "P" plan, you've also gotta enter the letter S in the Y/N page on the override if the drug gets approved. The "S" would be next to ROUTE OF ADMINISTRATION on that page (duh).
What is Culinary?
100
Dang, eBay can sure be a constipating experience sometimes. I was trying to buy that 1977 Pink Ford Pinto, but some goofsauce placed a higher (TWICE A DAY) than me and won it.
What is bid?
100
So, you assigned yourself a PA for a plan exclusion med, and you're about to process it. Well, don't do it, meatball! You cancel the thing, then fax this to the prescriber's office (in most cases).
What is an appeal form?
100
Just today, Melissa Bennett unleased a reminder email on us stating -- among other items -- "Please refrain from reviewing this plan’s prior authorizations unless you have been instructed to do so." She was referring to this plan, y'see.
What is Sound Health and Wellness?
100
Early on, you'll need to check the member's medication history to see if they took the same drug before. Use this function key for that and you'll be golden.
What is F10?
200
So, you've got a Dr who has a patient with a compound fetish. Well, if the doc sends us a compound PA, we'd better develop a fetish for entering this number into the request type field of the RxAuth screen.
What is 08?
200
Imagine saying the name Quentin Tarantino while you've got a cold in your nose (that would change the sound of the first letter of the last name, y'see). His initials, if spoken that way, would be (EVERY DAY).
What is qd?
200
It's time for Lite Criteria to light up your life. Among other things, you'll need to send an email with the template in it. What's the destination? This one, of course.
What is the National PA team (PA Support)?
200
A couple days ago, Sonya Pierce uncorked an email saying, "QA is noticing this not being utilized in some reviews ... please ensure you take the time to ensure you are utilizing the attached template and replace your old one with this."
What is the Call Tracking Template?
200
So you're adding some verbiage straight from the Call Tracking Template into the Rx Claim notes. And there's already a Problem in there? Well, you'd "Edit Problem" to add your notes by hitting this key.
What is F19?
300
If you check your handy-handy override sheet, you'll see that this handy-dandy NSAID med is one that requires a four-star override to go with its OI reason code and the ignore drug status of N.
What is Celebrex?
300
Remember the old British sports cars? Well, if not, you suck. But think of Jerry Seinfeld's "Summon the Hounds" American Express commercial, as it showed a black one. Which one, you may ask? It was the (MILLIGRAM), of course.
What is mg?
300
You finished your PA and it was approved. Good deal. Now, it'll be an even better deal if you check to make sure the faxes to the doctor's office and pharmacy were sent. You'd go into the "documents" screen, the place the number 7 next to this word.
What is OUTBOUND?
300
Earlier this week, our trainer disseminated an email containing this juicy stuff: "If you are renewing a PA that is still active and has not expired; remember to use ... this.
What is Auth Type: "2"?
300
In the RxAuth screen, it's entirely possible that you'll have to check on those pesky letters that get sent out to the pharmacy and doctor's office. To go into the documents screen, use this key.
What is F10?
400
Pre-service is one type of service in the RxAuth detail screen. But this type of service is the one you'd pick if the PA was renewing with the exact same dose and strength.
What is Concurrent?
400
You drank a two quarts of whiskey last night and I didn't. So now your head hurts and mine doesn't. (HEADACHE HEADACHE), take that, you lush!
What is ha ha?
400
DAILY
DOUBLE
You've got a cheesy duplicate PA and you're gonna cancel it. On the cancel screen, you'd enter "CTRCANDUP1" if we do NOT do this.
400
In that same juicy email, our trainer shared this other piece of juiciness, regarding a dual reject PA (IF you've approved the first one): "If you do start a 2nd request please populate this field on your 2nd request with the RxAUTH#"
What is related?
400
Sometimes, you're gonna be in desperate need of additional plan information ... for whatever reason. To get there from the Claim Tranaction Detail screen, you'd be using this key for "Detail", which would then get you to Additional Claim Info on the next screen, where you'd enter 8.
What is F7?
500
If you're gonna take 25 hours to process a PA for this plan, you're likely gonna get 25 lashes. It's the only plan that has a max processing time of 24 hours -- no more -- for *any* of their precious PAs.
What is Central Bancompany?
500
When you guzzle whiskey like that, you ain't gettin' no liver transplant from me. Not until you go to an (of each) meeting first.
What is aa?
500
Hey, slick! If you're gonna use the Lite Criteria template, and the bottom piece of information on it says "Rx Auth#", then you've got the wrong one. The updated one has this piece of information at the bottom.
What is Request Type (Selected/Tried)?
500
Well, lucky you, you've assigned yourself a Suboxone PA. Before your luck runs out, you'll be checking this website to see if the Dr in question is OK to prescribe the med.
What is SAMHSA?
500
DAILY
DOUBLE
Whoops! You just had a brain fart, and you found out you need to bring up the PA you just approved and finalized. Well, get the Rx Auth number, for crying out loud, then bring up the request (search) screen. Once there, you'll to use this key to bring up the search you need for the Rx Auth number.
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