Systems Check

What is Carelon used for?

Answer explanation

Advanced imaging (PET, CT, MRI, CCTA)

Genetic testing

What system is used to check precerts for radiation therapy?

Answer explanation

Evicore

Magellan is used for?

Answer explanation

Physician administered oncology & non-oncology

Real time processing of prescriptions???

Answer explanation

Prime

Prime prod

prod01

JIVA is used for?

Answer explanation

Predetermination notes

Health Managment information

PD denials

notes for our HM/MR staff

Session 1 is used for?

Answer explanation

ACRE

Refunds

INAP

Cobra

RECI

RECM

GEMS browse is used for?

Answer explanation

PHI contacts

group information

External contacts

CMM Rider?

• non- oncology specialty

• oncology

Answer explanation

Non-oncology

ONC rider

• Non-oncology

• oncology

Answer explanation

Oncology

When taking prescription calls, a good way to guide yourself in the right direction of quoting benefits is to ask for?

• the name of the medication

• how it will be administered (self-administered or physician-administered)

• If it has side effects

Answer explanation

When taking prescription calls, a good way to guide yourself if the right direction of quoting benefits is to ask for the name of the medication and how it will be administered (self-administered or physician-administered).