PA check
What are the outcomes for PA
APPROVED AND REJECTED
What tool do you use to start a PA?
Prompt pa
Do we cover lost/stolen/damaged medications?
No, only for natural disaster
a member is calling you to apply for a new plan, where do you transfer?
DMS
What does DNI in rxnova stands for?
Denied
What team handles pa for controlled substances?
HCPR
What tool do you use to make premium payments?
ebilling
Who handle natural disaster calls for rx?
HCPR
Member is calling to check the status of an application, where do you transfer?
Enrollment
What does PWE in rxnova stands for?
Paid with soft error - approved
What is the name of the process after a pa is denied?
Redetermination
What tool do you use to run a claim test?
Rxnova
What is MPPP?
MEDICARE PRESCRIPTION PAYMENT PLAN
What is prospective member?
new member joining humana
What does PAC in rxnova stands for?
approved with PA
What is the standard timeframe for a PA?
72 HOURS
Resources for Rx savings
coupons, doctor samples, manufactures.
Are you the right person to answer questions about Medicaid questions?
Yes
What does LIS stands for?
Low income subsidy
What is the standard timeframe for a expedited PA?
24 HOURS
What tool do you use to create a grievance?
Quickstart
Do you handle MPPP calls?
No
Are you the right person to answer questions about silversneakers?
Yes
What medications are covered under GLP1 BRIDGE?