Introduction
what does PBM stands for?
Pharmacy Benefits Manager
"R-E-S-P-E-C-T find out what ___ ______ ___ ___"
"it means to me"
-Aretha Franklin
What has to be broken before you can use it?
an Egg
what is the article number that is associated with Inbound Caller authentication -
000081472
We adhere to very strict guidelines to protect patient privacy. Does anyone know what United States legislation this falls under?
: HIPAA (Health Insurance Portability and Accountability Act
:What are the benefits that our Express Scripts Home Delivery Pharmacy provides to our patients?
The convenience of receiving medication in the mail o Up to a 90 day supply of medication (in most cases) o 24/7 access to Patient Care Advocates to educate our patients about the best use of their benefits, refill prescriptions, and more o 24/7 access to Patient Consult Pharmacists for counseling, Patient Care Technicians, and more
"We all live in a yellow ______".
"submarine".
-The Beatles
What month of the year has 28 days?
All of them
what is the 3 most common information used to authenticate a call that was not ivru authenticated
Patients first and last name , date of birth and zip code
PC RPh
Patient Consult Pharmacist Throughout our organization, we have highly trained and licensed pharmacists who have different areas of responsibilities, and they are the only employees in our organization licensed to perform those duties.
Before you fill a prescription, there are a few questions you should consider:
Is your medication covered by your insurance?
Do you have to fill your prescription at a certain pharmacy?
How much is it going to cost?
"ABC, easy as ______"
"1 2 3"
-The Jackson 5
What is always in front of you but can’t be seen?
The future
when authenticated a call from the retail pharmacy, you need to obtain the _____________ of the caller and document the notes
Full name
(PCT)
Patient Care Technician Just like our pharmacists, we have highly trained technicians that have varying specifications and licensing requirements based on their line of work.
How to fill a prescription.
First, you go visit a doctor/prescriber because you are not feeling well.
The doctor/prescriber writes a prescription for a medication based on your ailment.
The prescription includes – your name, medication name, dosage, strength, and instructions on how to take it.
"Girls just wanna _____"
- Cindy Lauper
I love to dance and twist and prance, I shake my tail, and as away I sail, wingless I fly into the sky. What am
A Kite.
True or false you can speak any of the patients account information to a Listed Caregiver
True
(RTL)
Resolution Team Lead
These individuals handle escalated calls and provide you with support for SOP interpretation. Exception: RTLs handle escalated Order Status related calls when the WeCare Relationship team is closed.
What do you know about Express Scripts?
express Scripts is a home delivery pharmacy
Express Scripts and Cigna combined companies
Express Scripts is a pharmacy benefit manager
"Don't worry, bout a thing. Every little thing's ____________".
"gonna be alright"
- Bob Marley
What goes up but never comes down?
Answer: Your age
If the caller changes during the conversation, what is the next step
speak the monitoring discloser
EPCA
Experienced Patient Care Advocate
These are individuals, like you, that take member calls in our Contact Center. However, they have gone through additional training to handle more complex procedures.