FastTrax Guide | Claims Detail | Claim Detail Manual | Call Category/Call Type | Complaints and Grievances |
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What is All Member Search
This allows internal users to search across clients for client
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What is Dispensing Unit
What is NCPDP standard product billing codes Values: Each; Grams; Milliliters?
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What is IVR
This tab has all call issues where the caller followed and entered the interactive voice response options.
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What is Patient Inquiry
What Call Category would you use for A member is calling because our records indicate her eligibility is expired?
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What is Guided Workflow
Where do you find the Complaint drop down?
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What is Duplicate Issue
A new issue can be created based on the last issue by clicking?
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What is Claim Type
This indicates the type of claim transmitted Example: Pharmacy or Member
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What is Pharmacy Demographics
Where would you find
1. Pharmacy ID 2. Pharmacy Address 3. Dispenser Type 4. Other Pharmacy Data |
What is Claim Inquiry/Data Entry
What Call Category will you use to reverse a claim for the pharmacy?
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What is Inquiry
If the incoming case does not include an expression of dissatisfaction and is from an individual seeking information the case will be categorized as an ?
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What is Fax Query tab
What tab is used to search, track, and work faxes received by the fax server?
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What is Ingredient Count
This indicates the total number of ingredients included in the compound drug?
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What is Clinical Tab
Where would you find
1. Submitted DUE/Professional Service 2. DUE/Professional Service Response 3. DUE Conflict 4. Patient Clinical |
What is Drug Inquiry
What Call Category will you use if a member calls to confirm if a drug is on the formulary?
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What is HIPPA
What is the acronym for Health Insurance Portability and Accountability Act?
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What is New Issue Tab
This allows you to create a new call issue
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What is Rx Origin
This indicates how original prescription was received by pharmacy
Example: Written, Telephone, Fax, etc. |
What is Service Date
Indicates the date medication is being dispensed to the patient.
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What is Reject Inquiry
What Call Type will you use if a pharmacy calls about a rejected claim?
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What is FWA
What is the acronym for Fraud, Waste, and Abuse?
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What is Brand Class Indicator Tab
What tab would you find the drug Manufacturer?
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What is Submission Clarification Code
What code Indicates that the pharmacist is clarifying the override?
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What is Adjudication Date
What is the date the claim processed through Magellan Rx Management POS system is called?
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What is Complaint
What Call Category will you when a Beneficiary is expressing dissatisfaction relative to the Medi-Cal pharmacy benefit?
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What is Appeal
If the incoming case is from someone disagreeing with and seeking reversal of the decision of a PA, it will be referred as an?
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