A
What does PDP stand for?
Prescription Drug Plan
What does the claim status PWE mean?
Paid with exception/ Paid with error
What are the 2 tools we use for RX calls?
RX connect pro and RX nova
What is the tool we use to find an in network Pharmacy?
Pharmacy Finder
A list of drugs covered by a prescription drug plan is called___________
Formulary
True/False
We can Add a PCP on PDP Plan
False
What is the date that drug list changes date effect?
January 1st
What does NDC stand for?
National Drug Code
Where do we locate communication sent to our members?
RT OR EMME
What does the green dollar amount on RX connect mean?
The best Price for the member.
or
the lowest price for the member
What does HCPR stand for?
Humana Clinical Pharmacy Review
What are the 3 PDP plans
Value
Basic
Premier
What are the drug stages?
Deductible
Initial Coverage
Catastrophic
Who handles Extra help Applications?
SSA
What is the TROOP for Drugs
$2100
Under which tab in RX NOVa can you check for Authorizations
Athorizations
Mail Order Address types
Shipping Address
Billing Address
Permanent Address
Alternate Address
What does the Limit amount for Mail order mean?
Maximum amount we can process payment for before the member needs to authorize
What screen on CI do we check Other insurance?
PEOC
Financial assistance programs
SPAP
PAP
Extra help