Across
- 1. IF A MEMBER HAD MET SPECIFIC CRITERIA TO QUALIFY FOR COVERAGE
- 3. WHEN A CLAIM REJECTS THAT IT IS TOO EARLY TO FILL A PRESCRIPTION
- 7. MEMBER IS COVERED BY MORE THEN ONE POLICY
- 12. WHEN THE INSURANCE DENIES A CLAIM DUE TO QTY
- 14. A SERVICE PROVIDING SUPPORT AND INFO WITH CLAIM ISSUES
- 15. THIS CREATES OUR BV TEMPLATES
- 19. INS REQUIRES CLINICAL INFO BEFORE APPROVING A MEDICATION
- 22. UNIQUE 10-DIGIT ID#ASSIGNED TO HEALTHCARE PROVIDERS
- 23. SHARED COST OF MEDICATION BETWEEN THE MEMBER AND THEIR INSURANCE
- 25. IS A SUBSIDIARY OF ELEVANCE HEALTH (FORMERLY ANTHEM)
- 26. GENERATIVE A.I. LANGUAGE EVALUATION TOOL
- 27. A COMPETITOR PHARMACY, SUBSIDIARY ELEVANCE HEALTH
- 28. USEFUL RESOURCE PLATFORM INCLUDING STAFFING UPDATES
- 29. INTERNAL CODES WE USE TO HARD STOP ADJUDICATION
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- 2. OUR INTERNAL RESOURCE CENTER
- 4. PLAN APPROVED CLINCIAL EXCEPTION
- 5. CARELONRX TOOL MENU
- 6. THIS IS WHERE WE SUBMIT MOST OF THE PRIOR AUTHORIZATION FORMS
- 8. NUMBER ASSIGNED BY THE FDA TO IDENTIFY DRUG PRODUCTS
- 9. A PROCESS IN WHICH A RX DRUG IS SUBMITTED ONLINE
- 10. AMOUNT OF MONEY A MEMBER MUST PAY BEFORE THE INS PLAN STARTS TO PAY
- 11. IDENTIFIES THE PAYER THAT WE ARE BILLING
- 13. WHEN A MEMBERS PLAN IS LOCKED TO A PHARMACY THAT IS NOT US
- 16. ADMINISTRATOR OF PRESCRIPTION DRUGS BENEFITS
- 17. HOME DELIVERY OF NON SPECIALTY MEDICATIONS
- 18. BILLING DOES NOT OCCUR ONLINE, OFTEN REFERRED TO AS PAPER BILLING
- 20. PERCENTAGE THE MEMBER MUST PAY FOR SERVICES INCLUDING MEDS
- 21. HEALTH INSURANCE PORTABILITY AND ACCOUNTABILITY ACT
- 24. COPAY SAVINGS PROGRAM ADMINISTERED BY AN EXTERNAL VENDOR PRUDENT