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Froggy Jumps
Froggy Jumps

Intro to Optum Rx

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Intro to Optum Rx

Froggy Jumps

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About this activity

Slides 1-19

Created by

Tiffany
Tiffany
United States
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Intro to Optum Rx

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Intro to Optum Rx
 

Froggy Jumps

Intro to Optum RxOnline version

Slides 1-19

by Tiffany
1

What does Optum primarily provide to support pharmacies?

2

What is MedRx?

3

Where is a claim sent after it leaves the pharmacy’s software?

4

What does “adjudication” mean in claims processing?

5

Edits are designed to help maximize pharmacy profit by reducing denied or unpaid claims.

6

What is the primary role of a software vendor in a pharmacy setting?

7

Usual and Customary is also referred to as what?

8

What is a Channel Partner?

9

If the Channel Partner is a reseller of MedRx services, Optum has a contract with the Vendor/Channel Partner, not directly with the Pharmacy.

10

Can a pharmacy bill through our services if they are not enrolled?

11

Does a Paid claim in Allwin guarantee a pharmacy will be reimbursed or paid for that claim?

12

Is a pharmacy required to have an NCPDP?

13

Is a pharmacy required to have a ptan?

14

Are any of the claims that run through our MedRX platform “live”?

15

Which services are commonly billed as professional claims?

16

What type of pharmacy claims does Optum process?

17

What does the NDC identify?

18

What is the primary role of a clearinghouse?

19

Which identifiers does Optum use to recognize pharmacy customers?

20

What does the plan use to identify the pharmacy submitting a claim?

 
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