The typical medication quantity dispensed by our Mail Service Pharmacy.
What is a 90 day supply?
100
A _________________ is an organization that contracts with a PBM to use its services.
What is a "Client" Y'all?
100
This tool in RxWeb or RxHD helps you to select a member's plan and enter a medication to determine if it is covered by the Member's plan.
What is "Formulary Lookup Tool"?
100
In the movie, "Wizard of Oz" what does Dorothy say when she clicks her heels together?
What is "there's no place like home"?
100
Complete this movie quote, "Is this Heaven? No it's ___________.
What is Iowa?
200
When a person has more than one Health insurance plan, ___________ ___ ____________ takes place.
What is "Coordination of Benefits"?
200
________________ is when the cost of medical services is shared by the insurance company and the patient.
What is "Coinsurance"?
200
The acronym for Low Income Subsidy is _______ ?
What is LIS?
200
_____________ is funded by the Federal government as well as individual States.
What is Medicaid?
200
The __ ________ number that identifies a medicine, manufacturer, dosage, and package size is the NDC.
What is the "11 digit" number?
300
mg
What is "Milligram"?
300
A __________ ____________ ______ is one that is patented.
What is a "brand name drug"?
300
______________ is the process of determining the amount of the claim that will be paid.
What is "adjudication"?
300
The ____________ ___ can be found on the Coverage tab?
What is the "Member ID"?
300
A list of drugs covered by a particular insurance plan is a ___________.
What is the "formulary"?
400
You may find the following in Compass, A. Telephone numbers and addresses. B. Bulletins. D. Breaking News.
This isn't a question at all, really. I'm just telling you what you can find there.
400
A ____________ is a preliminary determination that no benefits will be paid on a claim.
What is a "rejection"?
400
An authorized representative with a HIPAA task on file is required to provide _____________ & ___________ or ___________ to authenticate himself or herself on the account?
What are "Full name and 10-digit phone number or zip code"?
400
You receive a call from the guardian of a minor child who wishes to order one of the child's prescriptions. What member information must be authenticated?
What is "Member's full name, date of birth and complete address?
400
Tablets, capsules, creams, and ointments are measured by weight in _________.
What is "grams"?
500
The abbreviation "sig" is not short for the name "Sigmond" (that would be Siggy). What DOES it stand for?
What is "the directions"?
500
The ____________ function cannot be used when the medication is a controlled substance, is more than 14 days before the refill is available, there are no refills remaining on the prescriptions.
What is "TST Function"?
500
If an item is on profile but no refills remain or if the item has expired and no changes have been made to strength, directions or prescribing doctor the type of PSC to be sent is a ____________.
What is a "renewal"?
500
Acknowledging, Clarifying and Summarizing are all steps to ___________ ____________.