AS400
The Screen to add notes
BCN (Page 11)
Button to hit to make a PA
New Request
Who do you call when you cannot get ahold of a provider?
POS
Point of Sales
Site used to find email contacts
CRM
Fin Plan for Humana
DNHUM
How long does a PA determination take?
3-5 business days
We take this step in every single follow up
Rebill the claim!!
PCN
Processor control number
After how many days is a claim considered too old?
90 days
Code to reverse a claim
RV
What you search by to find medication name
NDC number
How soon after an All Attempts can we reopen a PA?
90 days
DON
Director of nursing
If a resident has multiple insurances, which do we complete the PA for?
The primary insurance listed first in the hierarchy.
Refill too soon rejection number
79
EPA stands for what?
Electronic prior authorization
What we need if we have the incorrect MD on file
New Script
ALF
Transitional fill
The page to find ingredients for a compound drug
Pharmacy Site number, 7 and then 13
What a MD can do if the PA denies
An Appeal
What info does the snapshot include?
Community name Patient Name DOB Drug Name RX Number Current Activity Comment CMM Key MD Name PH and Fax for MD
PCB and PRB
Post Consumption Billing and Prospective Billing
What group of medications do we not do PAs for?
Cough suppressants