Specialty myGrowth – Mod2 (69001247) Knowledge Check

What is the primary role of a Tier 1B outbound representative?

• To contact the doctor’s office if there is a question about insurance

• Verifying prescription benefits with patient’s insurance, determining the patient’s copay, handle requests for prior authorizations, and process claims.

• To enter the prescriptions in the system

• To contact the patient about scheduling their medicine

What are some resources you can find in the Specialty Admissions Database? Select all that apply.

• BV Note Creators

• Pharmacy and Therapy Information

• BV Payor Files

• Forms and General Information

What is Enterprise Information (EI)?

• A CVS site to look up internal employees

• A digital phone book

• A site to process insurance

• A web-based patient database tool that can be used during your benefits verification process.

Using the image below, identify where you would click to open the dispense maintenance screen.

• A

• B

• C

When researching a task, which items should you review in SPRx?

• Referral Images and Patient Notes

• Alert Message

• Previous Action/Outcomes

• All of the Above

This is the tab in SPRx that allows non-management users to unlock themselves from a task. (Module 2)

• Patients

• Left Navigation

• Prescriber

• Maintenance

What screen in SPRx do you have to be at to access the Payor Files Search? (Module 2)

• Patient Engagement

• Dispense Maintenance

• Order Maintenance

• None of the above

Using the image below as reference, what numbers should be entered for Actual Days Supply and Billed Days Supply? (Assume the Insurance will only pay for a month supply.) (Module 2)

• Billed Days Supply = 28, Actual Days Supply = 28

• Billed Days Supply = 30, Actual Days Supply = 365

• Billed Days Supply = 1, Actual Days Supply = 365

What does DNF stand for? (Module 2)

• Drug Not Fulfilled

• Do Not Fill

• Drug Non-Formulary

• None of the above

In order to process an ECS claim, you must navigate to which screen in SPRx? (Module 2)

• Patient Engagement

• Dispense Maintenance

• Order Maintenance

• None of the above