MailRX
Prior Authorizations
OneView
Terminology
EPro
100

What are the hot keys to find Allergies and Health Conditions?

What is P3 and P4

100

What is the system used to view Prior Authorization information?

What is PA Hub

100

If you need to look at notes from a prior call, what section do you look under in oneview?

What is interaction history - recent call history

100

What does DAW 0 mean?

What is Generic Substitution allowed

100

How do you access Epro?

What is you launch from OneView

200

If you are doing a refill for someone under the age of 18, what address do you need to select?

What is the HIPAA Address on file

200

What is the EXT you need to dial to speak to someone in the PA dept.?

What is EXT 89130

200

If you see an Orange OG listed, what does this mean and what needs to take place?

What is, the member has a OneGuide Account and if you are not OG trained, the call needs to be transferred

200

What does PPI stand for?

What is Proton Pump Inhibitor

200

What information is needed to open the correct Epro report?

What is the account # and plan name

300

If you need to add or update an address in MailRX, what must you do before entering the address?

What is look the address up @ USPS.com to make sure that its formatted correctly

300

A member calls and states that her dr. submitted a PA and she has not received any information. You check PA Hub and see that the PA was submitted and DNI - the member asks that the denial letter be resent, what do you do?

What is call the PA dept. and request that another denial letter be sent

300

Which option do you choose if you need to add a note to the account?

What is Requests/Tasks

300

What does NDC stand for?

What is National Drug Code

300

What is Epro used for?

What is to check benefits for 215 accounts

400

If the member is calling to pay a Balance on the account, from the Master Menu Screen, what is the first number that you choose?

What is 12

400

What is the turnaround time for routine PA request?

What is 3-5 business days
400

If you submit a request for a damaged medication - what do you need to do in OneView?

What is copy and past the notes that are generated in the CSITR request, past them in your notes section in OV and REASSIGN TASK to QCSITR

400

What does GST stand for?

What is Global Step Therapy

400
How do you search for items in Epro?

What is Control F

500

What does Origin Code "0" mean?

What is the order was started over the telephone with a CSA

500

If a member is calling about an appeal, what are the steps you would take to view the appeal in Oneview?

What is click "interaction history" the click the appeal/claim tab and review the appeal information

500

If a member places a New 261 Order, what Request Category and Request Name would you choose when noting in OV? 

What is Request Category = Orders-Mail Order Request Name = New Order

500

What does NABP stand for?

What is National Associate of Board Certified Pharmacist

500

What are the 4 items to search in Epro?

What is 1. Rider 2. Pharmacy Option 3. Plan Provision 4. Pharmacy Option comments