Prior Authorization Refresher

Froggy Jumps

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Refresher Game

Created by

Melinda Dunworth

United States

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#	Player	Accuracy	time
1	Melinda Dunworth March 20, 2025	% 100	01:25
2	Anna K March 25, 2025	% 86	01:54
3	Babz March 25, 2025	% 86	02:04
4	Nicole Williams March 25, 2025	% 57	02:29

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Prior Authorization Refresher


Froggy Jumps Prior Authorization RefresherOnline version Refresher Game by Melinda Dunworth 1 What is a Prior Authorization ? a A document that is used to lower cost of rx when approved rx is expensive b A document that is used to bill patient insurance c A document required by an insurance to be submitted to determine if rx will be covered 2 Where can an agent view the prior authorization status ? a Patient services , Full Profile, Prescription Tab b Patient Support Summary, Patient Overview, Common Actions, c Patient Experience Tab, Cx tool, Insurance tab 3 What does the Prior Authorization Status "Sent to Prescriber" stand for ? a MDO is now working on Prior Authorization b Insurance is now reviewing the document c Prior authorization document is now at MDO 4 What is the prior authorization status of The PA team or prescriber has submitted the PA a Sent to Payor b Discovery c Closed 5 When offering refill price base on business rules an agent can choose lower price when rejected if pa status is a Sent to prescriber b Sent to Payor c Closed 6 What prior authorization status the PA team will not continue to pursue the PA. a Discovery b Closed c Denied 7 If a patient calls to check on the Prior authorization status an agent will transfer the patient to the PA Team a Yes b No c 8 What does the prior authorization status Discovery stand for ? a The PA workflow has been created, but not yet acted upon. b The PA team or prescriber has submitted the PA request to the payor. c The PA team has submitted the PA request to the prescriber. 9 An MDO can be transferred to PA team for any prior authorization questions a Yes b No c 10 Prior Authorization Form are strictly used for denied claims a Yes b No c 11 Agents should be diligent informing patient Prior Authorization time frames of completion a No b Yes c Periodically 12 A pharmacist can override Prior Authorization decision a No b Case by Case c Yes 13 When transferring a MDO to the PA team it is always a cold transfer a No b Yes c When time is constricted 14 If patient states they have received a pa denial what's the next step a Open Prior Authorization Tab to verify b Place patient on hold to inform pa team c Escalate to Hub so we can get pricing

You can integrate the game into an LMS compatible with LTI 1.1 or LTI 1.3 such as Canvas, Moodle, or Blackboard. This way, the scores will be automatically saved into the platform’s gradebook.

Prior Authorization Refresher

Froggy Jumps

About this activity

Created by

Download the paper version to play

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Prior Authorization RefresherOnline version

by Melinda Dunworth

What is a Prior Authorization ?

Where can an agent view the prior authorization status ?

What does the Prior Authorization Status "Sent to Prescriber" stand for ?

What is the prior authorization status of The PA team or prescriber has submitted the PA

When offering refill price base on business rules an agent can choose lower price when rejected if pa status is

What prior authorization status the PA team will not continue to pursue the PA.

If a patient calls to check on the Prior authorization status an agent will transfer the patient to the PA Team

What does the prior authorization status Discovery stand for ?

An MDO can be transferred to PA team for any prior authorization questions

Prior Authorization Form are strictly used for denied claims

Agents should be diligent informing patient Prior Authorization time frames of completion

A pharmacist can override Prior Authorization decision

When transferring a MDO to the PA team it is always a cold transfer

If patient states they have received a pa denial what's the next step