By the Book
This percentage of days covered (PDC) threshold is required for a Medicare Part D member to be considered adherent to their maintenance medications.
What is 80%
These medications contain the same active ingredients and work the same way as brand-name drugs, but typically cost much less.
What are generic medications?
Before sharing any member information, you must verify HIPAA using this many different identifiers for OUTBOUND calls.
What are two identifiers?
Before ending a call, the Guide should review what was discussed and explain these, if applicable.
What are the next steps?
Click this button in the top-right corner of a member record to start sending a message?
What is +Activity?
These three key maintenance medication categories are tracked by CMS for Medicare Part D Star Ratings adherence measures.
What are diabetes, hypertension, and cholesterol medications
Penicillin and Hydrocodone are classified as short-term medications, while Atorvastatin and Metformin fall into this category.
What are maintenance medications?
During your call opening, you should introduce yourself by your first name and state that you are calling from this organization.
What is Devoted Health?
Before accessing a member’s profile to confirm information, this must be completed first.
What is HIPAA verification?
By spending extra time doing this, an angry member can often de-escalate themselves.
What is practicing active listening?
To remain compliant, Pharmacy Guides must avoid offering this type of guidance and instead connect members with licensed professionals.
What is clinical advice
This ACE inhibitor is commonly used to treat blood pressure and may also help protect the kidneys in certain patients with diabetes
What is Lisinopril
When speaking with a representative, these two pieces of information about the representative must be verified.
What are their full name and relationship to the member?
In addition to introducing yourself and stating you are calling from Devoted Health, you must tell the member this about the call.
What is that the call is being recorded?
The SMS Camaign chosen when performing outreach for prescription refills?
What is MAGII Med Refills?
Known as the address for an insurance processor, this 6-digit number routes prescription claims to the correct entity.
What is an RX Bin
The generic name for Lipitor and it helps with.....
Atorvastatin, it is to treat high Cholesterol.
During every call, Guides should communicate professionally and clearly and include this type of statement to show appreciation.
What is a thank-you statement?
When speaking with a representative, these two pieces of information about the representative must be verified.
What are their full name and relationship to the member?
This mental health support platform is described as the fastest path to feeling better for guides.
What is Lyra?
The first set of digits in a National Drug Code (NDC) identifies this entity.
What is the manufacturer or Labeler Code?
This brand-name SGLT2 inhibitor, whose generic name is dapagliflozin, is used for conditions including type 2 diabetes, heart failure, and chronic kidney disease.
What is Farxiga?
True or false: You may access the member’s profile to find an identifier that can then be used to complete HIPAA verification.
What is false?
Before closing the call, a Guide should confirm understanding and ask this specific question.
What is “Is there anything else I can help you with today?”
This heatmap level involves deflecting and getting the member back on track.
What is Yellow?
Deflect + Get the member back on track