Show:
Tools
CoWorkers
OptumRx
Pharmacy
Donuts ;-)
100
A structured method for taking notes.
What are Power Notes?
100
This department helps to:  Manage high-cost medications  Control the misuse of medications for off-label use  Ensure safety and improve therapy  Promote the use of formulary alternatives.
What is Prior Authorization?
100
These are maintained and managed by a third party company called a pharmacy benefits manager (PBM) such as OptumRx.
What are Pharmacy Benefits?
100
All pharmacies must have this present in order to dispense medicines that require a prescription.
What is a licensed pharmacist?
100
Health insurance for people age 65 or older, under 65 with certain disabilities, and any age with End-Stage Renal Disease (ESRD).
What is Medicare?
200
An interactive tool that assists you in performing your daily job functions by helping you access information easily.
What is Compass?
200
A company that provides prescription claims processing, formulary administration, and pharmacy contracting services.
What is a Pharmacy Benefits Manager (PBM)?
200
A PBM administers the pharmacy benefit on behalf of the insurance plan, and assumes a more behind-the-scenes role.
What are "Carved - In" Benefits?
200
A drug available both as a generic and a brand.
What is a multi-source drug?
200
Federal agency that oversees Medicare. Part of the U.S. Department of Health and Human Services.
What is CMS (Centers for Medicare & Medicaid Services)?
300
Site where e-learning lessons are listed for career development.
What is LearnSource?
300
Overland Park, Kansas, and Carlsbad, California.
Where are our fulfillment centers?
300
Stand-alone plans that provide prescription benefits only.
What are PDP plans?
300
A unique 11 digit identification number assigned to each drug product.
What is an NDC?
300
For beneficiaries with limited income and resources, individual states may help pay for this.
What is Medicare Part A?
400
A real-time claims and eligibility system
What is RxHD?
400
This department dispenses high cost injectable and oral medications.
What is specialty mail service?
400
A way for a coverage provider to limit the amount of money they spend on a member’s medical expenses by having the member pay a portion of the cost.
What is Cost-Sharing?
400
They regulate the safety and effectiveness of prescription drugs.
What is the Federal Drug Administration (FDA)?
400
This includes the deductible, any co-pays, and any amounts submitted in a claim but not covered.
What is TrOOP (True Out of Pocket)?
500
An application employees and managers use for Human Capital transactions. I.E.Time Reporting (US), Payroll and Compensation (US), Absence Management (certain countries outside of US), Personal Information, Career and Development, MAP, and LearnSource.
What is Global Self Service?
500
Provides customers, clients, and pharmacies with information related to online (electronic) claims processing of prescription benefits.
What is Pharmacy Help Desk?
500
Three segments making up the business platform launched in June 2011 by United Health Group.
What are OPTUMHealth, OPTUMInsight and OPTUMRx?
500
A drug classified as this to another may be prescribed as a substitute, with the expectation of producing the same medical benefit.
What is therapeutically equivalent?
500
All adverse formulary changes require a 60-day notification to affected members and will be listed on this for the member.
What are Explanation of Benefits (EOB)?