OptumRx Mail Service primarily send these types of medications to customers.
What are Maintenance Medications?
100
The typical medication quantity dispensed by OptumRx Mail Service pharmacy.
What is a 90 day supply?
100
Also known as Hospital Coverage.
What is Medicare Part A?
100
Contains all of the customer's information also known as the customer profile.
What is the eBusiness (eBC) ?
200
OptumRx® was formed by this company in 1989 to offer pharmacy benefits for its members.
What is PacifiCare Health Systems (PHS)?
200
A pre-determined dollar amount that must be paid by the customer before the insurance will begin paying anything.
What is a deductible?
200
The private health plan option where memebers have their own group of health care providers and beneficiaries generally receive care from the providers in this group.
What is a Medicare Health Maintenance Organization (HMO)?
200
If only one matching profile is found, the eBC displays with this tab showing, ready for you to authenticate the caller and conduct the business of the call.
What is the RxHistory tab?
300
In July 2011, UHG launched a new platform made up of these three segments.
***DOUBLE JEOPARDY***
What are OPTUM Health, OPTUMInsight, and OPTUMRx?
300
The period during which Medicare beneficiaries must pay all their own prescription costs.
What is the Coverage Gap or Donut Hole?
300
The total amount spent on prescription drugs by both the member and the plan.
What is the drug spend or Total Drug Expenditure?
300
We would NEVER use this information to authenticate a customer. (hint: Not order number)
What is the NPI or Person Number?
400
Diabetes Active Care dispenses respiratory and diabetic supplies for customers with this type of coverage.
What is Medicare Part B?
400
When the cost of medical services is shared by the insurance company and the patient.
What is coinsurance?
400
The federal agency that oversees Medicare.
What is the Centers for Medicare and Medicaid Services (CMS)?
400
These medications are identified by examining the Drug field in the RxHistory tab where their name will be proceeded by the letters CP.
What is a Compound Medication?
500
Only 1 of 26 call centers in the world to have this certification in 2011.
What is JD Power and Associates Certification?
500
The process of Determining the amount of the claim that will be paid.
What is Adjudication?
500
When a company chooses to directly contract with a PBM to provide pharmacy benefits management, and limit the services provided by an HMO strictly to medical benefits.
What is Carved-Out benefits?
500
An authorized representative with a HIPAA task on file is required to provide this to authenticate himself or herself on the account.