Program Information Policy & Operating Procedures
What does LMN stand for?
Letter of Medically necessary
If the caller is not already within the system, the Access Coordinator Do we create a record under the caller's name with the necessary collected information via a General Inquiry? True or False
True
How many digits are in patient ID numbers
10
If the patient Patient Savings Program assistance is exhausted will they be eligible for the Viiv Healthcare PAP? Yes or NO?
No -The patient will not be eligible for the ViiV Healthcare PAP if the Patient Savings Program assistance is exhausted.
Does a Evouche automatically get applied at the pharmacy?
Yes -eVouchers will be automatically applied at the pharmacy to qualifying claims with no need for the patient to apply for savings card or coupons
What does APA stand for?
Attested patient Advocate
Whats consider an emergency call?
Emergency calls include those calls where the caller threatens the health or safety of himself/herself or other persons including ViiVConnect representatives or other employees.
Can the patient ID number be used with HCPs, pharmacies, and with ViiV when the patient has completed an authorization form as part of the enrollment process.
Yes
Does Business reviews have to be scheduled at least 45 calendar days in advance ? YES OR NO?
No-unless travel is required
Whats the Evoucher RX Program
eVoucher Rx is an automated program operated by CoverMyMeds at participating pharmacies.
Whats the hours of operation at VIV?
8:00am-8:00pm ET Mon-Fri
Apretude J0739
Cabenuva C9077 and J0741
Whose the OLI triage to? what pharmacy?
triage the prescription through electronic data feed to TheraCom.
If phone or fax failure are more then 30 minutes what are you suppose to do?
Communicate to ViiV along with a root cause analysis and associated plan of action including an estimated time to repair
When are escalation trends reported to and reviewed?
Escalation trends will be reported to ViiV Leadership: During the Quarterly Business Meeting
How many holidays are we off for per year?
11 Holidays
If a new healthcare provider is identified during the intake process, what does the PN do?
The Patient Navigator will add a high priority FRM note as notification for FRM outreach to the provider/facility
Any requests for Planned Missed Dose beyond the standard limitations referenced Does not need to be escalated?
False-Any requests for Planned Missed Dose beyond the standard limitations referenced below must be escalated to ViiV for approval.
Does FRMs have access to patient financial information? Yes or NO?
FRMs will not have access to any patient financial information
Whats consider an emergency call?
Emergency calls include those calls where the caller threatens the health or safety of himself/herself or other persons including ViiVConnect representatives or other employees.
What is a P2P?
Physician appeals process available with certain payers where the HCP can present justification for a service on behalf of a patient to another medical provider for consideration for insurance approval
What happens on Day 8 of MI?
Case Closed due to MI
If multiple patient inquiries are presented during a call for patients without active cases, Does the Access Coordinator have to generate one General Inquiry case per inquiry regardless of the total count or all on the same ?
Generate one General inquiry regardless of the total count.
If the AC has reviewed the claims data in Lynk and the data shows a claim of $25.00 What is the AC suppose to do?
warm transfer to the claims adjudicator vendor, CRx, for additional assistance.
Whats the rebate program?
This policy details how program representatives support the ViiVConnect Rebate Program. If a patient pays out of pocket for an eligible, prescribed ViiV Healthcare medication(s) and does not utilize the ViiVConnect Savings Card, the patient can use the Rebate Form to obtain savings.