Transfer Calls
assist with the look up of a alternate drug
RPH
you would use this SOP to help explain Smart90
Voluntary Smart90 Medicare D, SOP 15.15M
you can give the member the wife information without his permission and without her name being on his account
false
what else can you use besides the phonebook to transfer a call
Guide me 2.0
what is rad code 891
Days Supply Is Less Than Plan Minimum
who can you call if PCT is closed
RTL or RPH
what sop can you use for prescription request
Renewal Prescription Requests, SOP 3.6
the TAT for a PA is 24 hours
True
what does OHI stand for
Other Health Insurance
What SOP is 12.3.1
Prior Authorization
Pharmacy calling for information on a medication
RPh
What sop can you use to get fax information for a prescription to get sent in
EasyRx (Faxing), SOP 3.3
member can cancel an order at anytime
false
What is done at the end of every call
Recap and offer survey
who can you talk to about packaged medication
reach out to PC RPH
member calling because to restart a prescription
PCT
caller hung up
Disconnected Caller, SOP 2.16
a test claim can be done to find out if a medication will be paid or rejected
true
what do you have to do if you have to reach out back to the member after being disconnected
Reauthenticate the call
Define formulary exception
A member request to obtain a formulary drug at a lower cost sharing or copay amount
member calling and stated that he\she will cause harm to his\herself
RTL
what sop can help you start a coverage determination
Initiate a Coverage Determination/Exception/Prior Authorization (PA), SOP 2.4.1M
you can Submit a P.A even if its not the member calling
False
what is the purple letter used for
to let members know that he\she re-qualified for Extra Help at the same level they were enrolled in for the previous benefit year
What is a tiering exception
Request for a non-preferred Part d drug at the preferred cost-sharing level