HIPAA
The Article the gives the difference between General information and PHI
What is 4975 - General Cigna Information versus Protected Health Information (PHI)
The 3 main Drug Tier names
What are Generic, Brand, non-preferred Brand
This is Cigna's preferred method of obtaining a NEW prescription for Mail Order
What it is to have the Doctor submit a prescription directly to us
The action to take when member wants the order status on a Specialty Medication
What is to Transfer to Accredo
What Authorization Effective Dates are considered as far as HIPPA information goes.
What is PHI
The section on the Product Coverage Details screen in eSD that tells me if a PA can be done
What is the Coverage notes section
The report that provides a detailed summary of prescriptions purchased through HD for a specified time period. These statements contain patient confidential information.
What is a SOBA Report
This icon indicates a Medication is temperature sensitive
What is The Thermometer Icon
The amount of calendar days it takes from the MCMIS protocol date that the member should receive their Free Glucose Meter.
What is 10 - 14 CALENDAR Days
What you must specifically get to Validate a Provider/Provider Office?
What is Tax ID or NPI
The transfer code you use to get a Customer to the Prior Authorization Department (CCRD) if they have questions?
WE DONT!!
The functions in eSD where I would locate the plans Copayment structure
What is Group Benefits > Benefit Overview > Copayment Inquiry
The field in RX Details that tells you how Express Scripts received the prescription?
What is the Channel Field
The 2 Free Non continuous glucose Meters a member can get through ES or Retail.
What are the One Touch Verio Flex & One Touch Verio reflect
Something else you can use to verify if the caller is stating the DOB we have is incorrect
What is the ZIP CODE
The processing time for a standard prior authorization request from the day we get it back from the Doctor
What is 5 Business Days
Where you would change the name to the member you are refilling medications for
What is The Persistent Header
What I must click on for duplicate Rx's to confirm which is Newest.
What is Check History
This is where I would transfer to If the customer has any Managed Care Interchange questions
PFED or Trend Team
The company who handles Specialty Prior Authorizations for non-chemotherapy pharmacy meds.
Who is Cigna
When a Member provides a New address Update this is what I must do AFTER they provide the full address but BEFORE I hit Submit
Repeat and spell back the address to the customer in full prior to submitting.
We will attempt to contact the doctor for a prescription in eSD this many times
What is A total of 4 times.
What you do when a caller states the wrong name is on their medication bottle
What is Contact an RPH