ALORICA- HIRING QUIZ QUESTIONS AND ANSWERS WITH COMPLETE SOLUTION

ALORICA- HIRING QUIZ QUESTIONS AND ANSWERS WITH COMPLETE SOLUTION what does "mg" stand for Ans- milligram according to our customer advocacy principles, which of the following would least be appropriate in solving a problem? Ans- I need to direct the customer to higher power if he/ she is upset. what is the 11 sit number that identifies a drug by the manufacturer, dosage and package size called? Ans- ndc OR national drug code what is the correct term used for the formal process by which a prescriber requests approval from the insurance plan to cover a service or product? Ans- Prior Authorization What does "day supply" mean? Ans- The number of days it takes the member to finish medication. what does it mean when a drug is brand name medication? Ans- A drug that has a patent and has a trade name how many days will a box of 100 test strips last if a member with diabetes tests his blood sugar diligently before each meal (bkfst, lunch and dinner) and at bedtime? Ans- 25 Days a _________ describes the preliminary determination that a claim will not be paid. Ans- Rejection what is the appropriate response to say to a customer complaining about long hold times on monday? why does it take so long for you to answer my call on mondays? this happens everytime i call on monday. Ans- Sorry for the delay, our lines are, less busy in evenings, weekends and mid-week _________-fixed amount to be paid by member when receiving products or services. Ans- Copay _________ pre-determined amount paid by the member before insurance begins to pay. Ans- Deductible _________-amount that the member pays for service, whether it is covered or not. Ans- Out of pocket __________ - recurring payment made by the member for insurance coverage. Ans- Premium _________ is not an appropriate part of active listening, according to our customer advocacy principles. Ans- Debate When in My RxAdvisor, decision trees can be found in _________ Ans- Interview when in my rxadvisor, any bulletins that have been released in the last two weekends can be found under__________ Ans- Service Alerts If a member has received A Medical service and has coinsurance, the cost of the service would be shared by:____________ and _____________. Ans- member & insurance if you receive a call from the plan requesting an update to eligibility, you must make sure that the caller is an authorized person. Ans- Plan Contacts (find them in RXHD) The caller is authorized to request the eligibility update. You would select the __________ tab to update eligibility. Ans- Member Demographics What is formulary? Ans- a list of drugs covered by insurance plan When using the formulary lookup tool Ans- select the members plan, enter drug name to determine drug is covered james jones would like to appeal a decision about his drug coverage. how would you determine if optum rx handles the appeals for his plan? Ans- Plan contacts (rxhd --> benefits) jane smith has been diagnosed with diabetes and she would like to know which blood glucose monitors are covered by her plan. Ans- Programs you click the formulary look up link in rxhd and noticed that the plan name does not auto populate in "select a plan" field. which link would you select to locate the name of the plan formulary? Ans- Formulary Information which of the following is correct to add a member's allergy information to IRIS? Ans- Zoom --> member allergy form which critical area in IRIS should you document if the call requires action by another team or department? Ans- Task a psc order can be sent as a renewal medication request when: Ans- customer out of refills and no changes to directions, strength or prescriber which of the following resend requests should be handled by the consulting pharmacists? Ans- Controlled Substance When adding a new member in IRIS, which form will open and display after searching the eligibility and importing the members file? Ans- Address (dash board)