Insurance Verification
A plus sign on a CRM profile indicates what?
That the pt has a Humana supplement plan
What plan ID should be loaded for a LINET plan?
Medicare ID #
What non-Humana plan IUDs go to MM?
Tricare
What year did Humana Specialty pharmacy change to Centerwell?
2022
When receiving the error 221 where do you search for additional insurance information?
Zirmed
What go link takes you to Humana radio?
go/x or go/radio
Name at least five states that ship out of pharm 40
Florida, Georgia, Texas, California, Oregon, Alabama, South Carolina, Connecticut, Hawaii, Oklahoma, Washington
When should you end a MM plan in SM?
Only if you have determined the Humana plan has been termed. (Part B should not be termed by anyone that isn't trained in MM)
How many attempts do you have to make to contact a non-Humana plan?
Three
Who is our current CEO?
Jim Rechtin
What does error code 005 mean?
Patient is deceased.
What go link do you use to access your schedule?
Who do you email for a 033 override or a multi-formula override?
rspa1@humana.com
Name 3 places to look for insurance for a patient
CRM, Evincemed, images, RX Nova
What insurance company did we recently stop filling for?
Express Scripts
What website do we use to track our healthy habits?
When receiving all 3 error codes 033-048-158 where do you send this referral?
PA Review
What go link do you use to enter your time?
go/workday or go/w
Where do you send a referral that has been Pv'd and needs a pharmcode mismatch fixed?
PCB - RPH Verification
what plan is loaded for a Careplus?
Humcare
What two states medicaid plans do we not have to call for regardless of valid denial?
New York & North Carolina
Who is the president of Centerwell Pharmacy?
Sanjay Shetty
When receiving error code 268 and unable to locate Part D insurance what do you do?
Push out with cash price template.
What is the go link you need to do your CBTs?
go/lms or go/learningcenter
What piece of information is required to look up medicare information in Zirmed?
Medicare ID
After adding insurance and notating, what step must you take before releasing referral to IV?
COB the plan to the drug
For Caremark commercial plans, what are the acceptable errors that are able to be sent to PA review
70, 75, or MR
What link would you use to get started on opportunities to further your education with Humana - paying some or all of your tuition?
go/guild
What does error code 517 indicate?
Enrolled in Patient Assistance Program.
what go link takes you to the Citrix /Scriptmed icon?
go/launchpad