Prime
What is Prime's Purpose?
To help people get the medicine they need to feel better and live well.
What does PBM stand for?
Pharmacy Benefit Manager
What is Ms Lucy's role?
Trainer of Unicorns
The amount the member must pay before they gain benefit from their plan is called?
Deductible
Gordon Ramsay
What type of company is Prime Therapeutics?
A Pharmacy Benefit Management company (PBM)
Drugs that have the same active ingredients as "brand" but are manufactured because the patent for the brand has expired are called what?
CALL 911 AKA POLICE
Which supporting role provides support for both the agents and the supervisor? There is one per team.
Something specifically listed as not being covered by and insurance policy is called what?
Plan Exclusion
In pool, how many of the balls are stripes?
Seven - balls 9-15
When was Prime incorporated?
1998
What does the member pay to the plan for medical and pharmacy coverage?
Premium
People who assist retail pharmacies with general inquires and rejected claims are..
Pharmacy Help Desk Agent (PSA) ((YOU))
Shawn has spend $2,000 on his medication this year. His copay is $25.00. The pharmacy informs him there is no cost for his medication for the remainder of the year. What is this known as?
Out of Pocket (OOP)
In what state is it illegal to eat chicken with a fork?
Georgia (Gainsville, GA to be exact)
Where are our vendor locations?
Denison, Texas
What two pharmacies are part of the Prime-Walgreens Alliance?
Mail order pharmacy and Specialty Pharmacy
As a MSS, you will assist member of Blue plans as well as DTEs. What does DTE stand for?
Direct to Employer: These are groups who may or may not have a Blue Plan as their health provider. These are also referred to as National Accounts.
A drug either not listed as being covered OR has a higher copay than the standard brand copay is known as?
Non-formulary
In what state is it illegal to fish while driving across a bridge?
Florida
Approximately how many members does Prime serve?
27 million
The total cost of Jim's medication is $27.00. He must pay $2.70. What type of payment structure is this?
Percentage/Co-Insurance
People who assist providers offices with prior authorizations are known as ..
Pharmacy Help Desk Agent (PSA) ((YOU AGAIN))
Shawn has received $5,000 on medications this year. His copay is $25.00. The pharmacy informs him he will have to pay the entire cost of the prescription order instead of $25.00. What is this known as?
Coverage Limit/Maximum Allowable Benefit
When playing a standard game of darts, what is the maximum amount of points you can score on three throws?
180 - Triple '20' three times.