Show:
Abbreviations
Links
Peoplesafe
Rxsource
Scenarios
100
doctor phone call team
What is DPC?
100
Where is the client code located in 1G?
Top left corner
100
Where can you find where the members ROCC is?
Virtual pharmacy hyperlink on main screen.
100
Where do you find if you have pending Acknowledgements you have to go through?
My RxSource
100
Rph calls in and wants a Copy. What do you do?
Ask if they got a fax. If they did, get first, last name and NPI# and warm xfer them to 29920. If they didnt give them the direct RPh xfer line and cold xfer them over (29073).
200
Future fill
What is FFL?
200
Where can you check to see if issue is Changeback related?
RX Versions or 1H
200
Why does CCS use the View activity tab?
To see who has been in the file and what they did with the member.
200
How can you save a document to your favorites?
Click on the documents hyperlink and click "Add to Favorites" at the top of the document.
200
Mbr calls in and wants to know why we are not filling their Oxycodone. Clinical or Non-clinical?
Clinical. Rph or tech?
300
forced conflict
What is FRX?
300
Where can you add a diagnosis/ allergy code?
In patient profile under the member/dependent tab at the top of 1G.
300
Where can you find if Caremark sent the member a letter regarding one of their prescriptions?
Communication History
300
If you need to look for a specific document, where can you go to do this?
Advanced search at the top right of website.
300
Customer service calls over and says the member needs alternative to Omeprazole because its not covered under their plan. What do you do?
Pull GPI number up in Drug sub and see what alts you can find. Run other "zoles" in test claim tab in Peoplesafe. If not able to find alt as a tech, xfer over to rph for further asst.
400
Participant services
What is PSC?
400
When do you put comments under prescription level?
When you d/c rx, transfers, as well as bridge supply and mchoice. <--- will learn later in course.
400
Member is calling in for a refill, where do you go and what do you do?
Order placement, select rx from file, "Continue" button, click show cost button to see copay, advise member of copay and read disclaimer. Verify address and phone number and method of payment. See if they want any special shipping. Click "charge payment" and give member confirmation number.
400
How do you acknowledge a document?
After clicking on the hyperlink for the document, read document and click on Acknowledge button after done
400
Customer service calls over and wants to know what is going on with an order. Is this clinical? What do you do?
Non-clinical. Search in system and try your best to help them figure out what is happening. Check in Notepad, Comments, and 1H to see any clues. Even through this is non-clinical we still want to try our best to help them.
500
Maximum allowable costs
What is MAC?
500
Where do you find the Intervention outcome?
In 1H, middle of page to the right. This tells what is currently being done on the rx.
500
When you pull up Lantus Solostar Pens in the Test Claim tab, what does the 15.0 indicate next to Package size?
The mLs of the package. There are 5 pens per pack and each pen is 3ml, 1500 units per pack. Peoplesafe uses the mLs as the package size instead of the pens or units.
500
If you are having a hard time finding a document, what might you have to change in order in find the document?
Change personal setting to ALL Facilities, All audiences, All platforms.
500
Member is calling because their pill looks different and they are afraid to take it. Clinical or non-clinical?
Clinical. Rph or tech? Under Drug sub you can find all the drug info.