Data Entry
Ind IN OOP is the short way of saying this.
What is the Individual in network out of pocket?
The TN used when told, this plan "comes after" Medicare "protocols"
What is This plan follows medicare guidelines?
This is what we should enter when told Humana Specialty Pharmacy.
What is Centerwell Specialty Pharmacy?
A tasty baked treat; or payer Intel.
What is pie?
rutn udaron mtie
What is Turn Around Time?
The portion of the reference number shown here that is no longer used. "Bob D 10022024 1152am CST"
What is the time zone?
This TN is used when we have attempted an escalation for COB type without successfully reaching a supervisor.
What is "Escalation attempt made, no supervisor available."?
When an Agent provides Specialty Pharmacy (PIE says SP not available), we use this task note.
What is "Representative confirmed specialty pharmacy is available."?
The smallest amount of 'digits' a PA approval number can contain before a push back is needed.
What are 6 digits?
napl rtsamdeinie yb presaeta tprteamedn
What is "Plan administered by separate department."?
The funding type we enter when told "Partially Funded", "Level Funded", and "Employer Funded".
What is Self Funded?
The task note used when approved PA units have been exhausted.
What is "Representative confirmed all units/treatments have been used on approved prior authorization."
The tab of the SOP we would use if trying to locate the phone number for Maxor Specialty Pharmacy.
What is the Xolair SP phone & fax tab?
This task note is used when J code doesn't require PA, but the Admin does require PA.
What is "For Admin code xxxxx, the prior authorization needs to be submitted to XXXXX department at XXXXX." ?
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What is Contact Local?
The standard data entry for BCBS, when "How to be considered in network?" is unknown.
What is "Contact Local"?
The task note used when we are calling BCBS TX, but the provider's state is CA. (Specialty Pharmacy)
What is "The local BCBS Specialty Pharmacy will be determined upon approval."
This is the 10 digit phone number for Bioscript Specialty Pharmacy.
What is 866-788-7710?
They are the only insurance company we can say "yes" to when asked if the provider will buy and bill.
Who are BCBC Massachusetts?
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What is the Ocrevus PA Flow Chart?