Easy
What are the 3 member identifiers in authenticating a caller?
Member ID, Date of Birth,Zip Code
How do you measure NPS?
Promoter - Detractor/#of surveys x100
What is RXNova error code 080,
Refill too soon.
Give 3 examples of PHI aside from Humana ID, DOB and Zip code.
SSN, Plan type, Primary Care Manager, Referrals,Other Health Insurance, Medical Records, Telephone, Email address.
What are the 4 stages of Medicare Pharmacy Benefits.
Deductible stage, Initial Coverage Stage, Coverage Gap Stage, Catastrophic Stage.
What is the process for vacation overrides?
Transfer to Member's Pharmacy.
What information will you find only in the Reimbursement section of RXNOVA Call connect
DMR Check and payment status.
The tool used for quoting benefits.
CRM DEBUT
What screen in CI do we update the PCP?
PAMG
Do we offer survey in every call?
Yes
What percentage will Humana covered in coverage gap?
25%
HMO Plan
What is the correct action taken for members requesting coverage for glaucose meter?
Advise them it is covered under their Part B DME Benefit and determine whether an authorization is required.
Where would you check the status of a mail order?
Rx connect pro