- Please choose your current supervisor's name*
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- Log into the Program Database
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- Request cases
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- Tagging Case
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- Complete BI Tool
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- Open the Conducting a Benefits Investigation
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- Open case and identify patient, prescriber, payer
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- Determine the patient’s payer type
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- Contact the payer and gather patient coverage information
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- Enter / align the patients payer information in the program database
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- Gather the patient’s benefit information from the payer
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- Enter the patient’s benefit information in the program database
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- Gather prior authorization / pre-determination from the patient’s payer
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- Enter the patient’s prior authorization / pre-determination information into the program database
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- Determine if a patient has a secondary plan
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- Contact the secondary payer and gather information
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- Enter the patient’s secondary policy in the program database
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- Determine if the patient has Medicare
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- Determine if Medicare is the primary or secondary payer
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- Determine if patient has Medicare Advantage Plan
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- Contact Medicare or Medicare Advantage payer to gather coverage information
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- Enter patient’s Medicare or Medicare Advantage coverage into program database
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- Complete case and task the case to the GNE case manager
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- Task Case Manager for Missing information
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