Micromedex
When you search for a drug we choose results from which country?
What is: The US
Where a child case routes to when a case is split
What is: My Workbasket
This tab provides information such as "All symbols must be removed, or replaced with words, from templates or referenced criteria before submitting"
What is: Things to Know tab
These letters designate the order for what?
P = Primary
S = Secondary
0= Other
What is: COB
When a Jcode is missing from the crosswalk techs are asked to use what criteria
What is: Compendia
This category can be used to find Federally approved uses for a drug
What is: FDA Uses
This is the location a tech will navigate to when documenting an outbound call
What is: actions > communication
In which tab would you find this statement and other similar statements: This drug has been approved. Approved quantity: ### DOSAGE FORM per XX day(s). You may fill up to a 31 day supply. Please call the pharmacy to process your prescription claim.
What is: Approval Messaging tab
Based on the SA a Standard Medicare Urgency request needs to be completed in how many hours?
What is: 72 hours
During admin review and the case is a benefit denial the techs will select "Review Status" and then asked to select an appropriate reason for denials due to missing information such as member information or quantity
What is: Lack of Information
Strength of Recommendation is found here
What is: Information bubble or (i)
This tab allows the tech to review previous request
What is the Authorizations tab
Templates that are used more often then others can be found in this tab?
What is: Frequently used templates tab
When denying for benefit, what would you select for the Review Status?
What is: Admin Review
These are considered Basic Missing Information (only one is required)
What is:
Drug Name, Dosage, Frequency and Length of Treatment
This options allows you to view quantity and how administered
What is: How Supplied
Information from this field along with the Jcode allows the techs to use the Medical Criteria Crosswalk successfully
What is: Product Market
This type of message can NOT be used
What is: a Voicemail
No Clinical Summary is required for which approvals?
What is: Standard buy and bill approvals
A request missing only length of treatment should what?
What is: Not be cancelled for basic missing info
This tab allows you to locate the NDC number
What is: Tax & Drug Product Lookup
The diagnosis information date from and thru needs to match this sections date from and thru
What is: Procedure Information
Which tab would you find this statement in: You have met the drug criteria, but we cannot approve the full length of therapy.
What is: QAI Step Therapy tab
A screenshot of Micromedex with the approvable diagnosis notated is used
What is: No drug is listed on the crosswalk
This is the name of the document that should be used when dealing with missing information
What is: Step Action RxMedical Missing Information Process