Claims Landing Page
Jenny White is calling because she received a statement in the mail, advising that her account balance is $535.00 past due. Where would you click to verify the amount Jenny White owes on her account?
The Claims Landing Page tab
The Mail Order Payments tab under the Member Snapshot Landing Page
The Accumulations hyperlink in the Quick Actions panel
The View Claims Across Carriers hyperlink in the Quick Actions panel
What is the claims landing page
When taking calls in production, what type of case should you open?
Research Case
Interaction Case.
What is Interaction Case
Once you have completed a call, what must you click to log your activity?
Close Case.
Create Support Task.
Edit Comment.
End Call.
What is close case
Mark Sharpe’s order for his Eliquis medication carries a high copay and he is requesting to pay this amount in installments. When you research Mark’s CIF, you determine that his client allows for a Copay Installment option for members. Mark is requesting to use his HSA card to offset his monthly installment payments. Can Mark use this card as the default for his Copay Installment request?
Yes
No
What is no
Yvette Nicholls has recently been prescribed multiple medications for complications, after working in a lead factory for over 30 years. Yvette has a list of prescription from her doctor and would like to get cost estimates before taking them to the pharmacy. She is anxious that this will take a long time, and she cannot hold her phone for a very long time. Randy, the CCR, advises Yvette that this will not take long and asked for her to read out her list of medications. How many Test Claims can be completed at once in Compass?
15
10
20
5
What is 20
You are placing a New Rx Request for Jenny White in Compass for her Xarelto 1 MG and Bupropion 75 MG tablets. You have navigated to the Place a New Rx Request Drug and Dosage Screen. What is your next step?
Click the checkbox next to the applicable medications and click Next.
Click Next.
Click the checkbox next to the applicable medications and click the Add Selected button.
Click the Find another drug hyperlink.
What is click the checkbox next to the applicable medications and click the Add Selected button.
Imagine that Rebecca Flack calls to request a Claim Form from Customer Care for a reimbursement on medications she paid full price for, which are normally covered by her insurance. While performing the member resources process, you receive a Mail Service Order Form Request pop-up. What does this pop-up signify?
a.There is a potentially better, option available for Rebecca to obtain the Claim Form.
b.You must contact the Senior Team for assistance in processing the Claim Form request for Rebecca?
c.There was an error processing the Claim Form request.
What is There is a potentially better, option available for Rebecca to obtain the Claim Form
Miriam Spencer, a pharmacist, is calling on behalf of a member. In Compass, during the caller authentication process, on the Pharmacy Information pop-up, what information will Miriam have to provide?
Pharmacy location number
Pharmacy telephone number
Pharmacy NPI/NCPDP number
Pharmacy address
What is Pharmacy NPI/NCPDP number
Morgan Anderson is calling because the pharmacy told her that her medication claim rejected for her Lipitor 20 mg tabs. She explained that she was taking one (1) pill a day, but her doctor has increased her dosage to 2 pills a day. You need to check to see if a dosage change override will be allowed. What can you use in Compass to determine if this override will be allowed?
Create Dosage Override
Override/PA Status
Calculate Quantity Row Level Action
Dosage Calculator
What is dosage calculator
When enrolling a minor into the Auto Refill Program, where must you send the prescription order?
The caller’s known mailing address.
The cardholder’s address or the adult spouse’s primary mailing address.
None of the above.
The minor child’s known mailing address.
What is The cardholder’s address or the adult spouse’s primary mailing address.
Megan Trim is very low on medication and is concerned about running out before the next refill gets delivered. She calls Customer Care to see what can be done, given her situation. The CCR determines she is eligible for Bridge Supply and proceeds with the process. After accessing the Mail Order History tab in Compass, what would you do?
a.Access the Mail RX tab.
b.Click the New Rx hyperlink.
c.Click the Order number link for the order in question.
d.Click the Create Override /PA hyperlink.
What is click the order number link for the order in question
Paula Hilfiger has called to update her Mail Order Payment Method on file. From the Member Snapshot screen, where will you click to start the process?
a.Check the Eligibility tab.
b.Click the Claims tab.
c.Click the Mail Order Payments tab.
d.Click the Mail Order Profile tab.
What is click the mail order payments tab
Beverly Adams is calling with questions about the Paper Claim she submitted. You need to review the paper claim information that she submitted. Where would you click?
Click the Paper prescription number hyperlink in question.
Click the Client program offerings hyperlink.
Click the Paper Claim Viewer hyperlink.
Click the New Rx Request hyperlink.
What is Click the Paper Claim Viewer hyperlink.
Martha Williams is prescribed Advair HFA by her physician to help manage her asthma symptoms. She was advised by her physician that she would be taking this medication for a long time. Concerned about the cost, Martha call Customer Care to get a cost estimate for her medication. Since this is a packaged medication and must be calculated, what should you click to ensure you are providing an accurate cost estimate?
Dosage Calculator
Calculate Quantity
Member Details
Special Handling Drug Limitations
What is calculate quantity
Imagine that Mark Blinds is calling to request a New Rx for his Eliquis medication from his provider. While doing so, he also requests a New Rx for his daughter, Felicia Blinds, for her Advair Diskus AER 50/150 inhaler, from her pediatrician. In Compass, will you be able to request both New Rx’s for 2 different family members, and from different providers at the same time.
Yes
No
What is yes
Paul Burns placed an order for Lipitor 10 MG tablets 5 days ago. He is running low on medication and calls Customer Care to check on the status of this order. Where must you navigate to locate the Order Status in Compass?
a.Claims Landing Page, and then click Mail Order History.
b.Claims Landing Page, and then click Mail Rx.
c.Claims Landing Page, and then click the New Rx Status tab.
d.Claims Landing Page, and then click the Claims tab.
What is claims landing page, and then click mail order history.
Timothy Jones went to the local pharmacy to fill his Lisinopril 10 MG tablets and was told that the copay was $60. Timothy was surprised by the cost of the medication and inquired about this price from the pharmacist. He was advised that he had to pay the full cost of the medication because he did not meet his annual deductible. Timothy calls into Customer Care because he thinks he had already met his deductible a month ago. Using the screenshot provided, where would you click to check Timothy’s annual deductible?
The Mail Order Profile tab on the Member Snapshot Landing Page
The Claims Landing Page tab
The Accumulations hyperlink in the Quick Actions panel
The View All hyperlink in the Opportunities panel
What is The Accumulations hyperlink in the Quick Actions panel
When viewing the status of a Prior Authorization and you are on the Override/PA History screen, a list of ePAs submitted in Compass will be displayed. How many days of ePA transactions will be listed?
120
10
60
90
What is 90
Racheal Test is calling to check on the status of her Claim reimbursement submitted 15 days ago. To view this information, where must you click to begin this process, after accessing the member’s account?
a.Client program offerings hyperlink on the Quick Actions panel from the Claims Landing Page.
b.Mail Order History Tab from the Claims Landing Page.
c.Paper Claim Viewer hyperlink on the Quick Actions panel from the Claims Landing Page.
d.Mail Order Payments tab from the Member Snapshot Landing Page.
What is Paper Claim Viewer hyperlink on the Quick Actions panel from the Claims Landing Page.
Peter Pan called Customer Care to check if there are any low-cost alternatives he can use for his prescription of Lipitor to help manage his high cholesterol. Where will you locate the alternatives for his Lipitor prescription.
Contact the Senior Team and ask for assistance in locating the alternatives for the medication in question.
Click the pencil icon under the Mail days column to see the applicable alternatives.
Click the View hyperlink under the Alternatives column of the List of Test Claims to Run section.
Click the find another drug hyperlink on the Enter Test Claim Criteria screen.
What is Click the View hyperlink under the Alternatives column of the List of Test Claims to Run section.
Joey Wilson is calling because his doctor has prescribed a new medication for him to begin taking. He is on a fixed income. Therefore, he would like to know how much the medication will be each month. Where should you navigate to begin the process of running a Test Claim?
a.Accumulations
b.Member Snapshot screen
c.Claims Landing Page
d.Mail Order Profile
What is the claims landing page.
In Compass, how can you identify if a member has Program Opportunities that they can implement to take full advantage of their benefit plan? Select all that apply.
a.An Orange messaging banner on Member Snapshot Landing Page or the Claims Landing Page
b.By reviewing the Opportunities panel on the Member Snapshot Landing Page
c.By viewing the details found in the Member Details section of the Alerts panel
d.By clicking the View Opportunities hyperlink in the Quick Actions panel
e.By clicking on the Rx number hyperlink on the Claims tab, to display the Rx Details
What is
a.)An orange messaging banner on member snapshot landing page or the claims landing page
b.)By review the opportunities panel on the member snapshot landing page
Martha Smith calls Customer Care to place an order for her Simvastatin 10MG tablets. She would like to have the ability to do this on her own, rather than having to call Customer Care all the time. You educate Martha about Caremark.com and its self-service tools available to members. What must you do first to assist Martha in getting registered on Carmark.com?
Check the CIF to determine if there are any client specific instructions regarding Caremark.com and Single Sign On (SSO) requirements.
Send Martha the quick registration link to her mobile phone.
Send Martha the quick registration link to the email address on file.
Send Martha the quick registration link to any email address of her choice.
What is Check the CIF to determine if there are any client specific instructions regarding Caremark.com and Single Sign On (SSO) requirements.
Donna Williams is calling to refill her Eliquis medication that she is taking. You are in the process of placing the order. The total cost of the medication is $0. However, per procedure, you still asked Donna for a payment method to add on file. Donna declines and says that she is not willing to put her credit card on file when the medication has a $0 copay. What should you do?
Transfer the call to the FastStart department.
Choose “Member does not want to add payment” from the options.
Transfer the call to the Senior Team.
Notify the member that you are unable to place the order unless a payment method is on file.
What is Choose “Member does not want to add payment” from the options.
John Clark calls Customer Care because the medication his doctor prescribed is rejecting at the pharmacy for NDC Not Covered. John would like to initiate a Prior Authorization to see if the medication can be covered. Where, in Compass, can you initiate an Electronic Prior Authorization (ePA)? Select all that apply.
a.From the Member Snapshot Landing Page
b.From a valid PA rejection on a Test Claim
c.From any rejected test claim.
d.From a valid PA rejection claim from the Claims table
e.From the Claims Detail screen
What is
b.from a valid pa rejection on a test claim
d.from a valid pa rejection claim from the claims table
e.from the claims details screen