RTM
What tab comes second in RTM?
Diabetic Supplies
What button do you select to make a case in crm blue?
Closing. Your decision today has no impact on your plan membership
How do we get a dual?
Asking for other members in the home
Name plus 3 identifiers:
DOB
ZIP
H#
Medicare ID
Phone number associated with account
Street or House address
What is the first verbatim you read before entering RTM?
May I have your permission to view your humana prescription claims?
This one time permission is voluntary and has no impact on your plan benefit.
Where can the POA/Consent form be found?
Details tab
What must be read before providing prices?
Pricing Disclaimer
What should follow ... "thank you for choosing to learn more about centerwell pharmacy..." in your greeting?
Formally Humana Pharmacy
Should we ask general or specific questions about medications?
Generic question such as "do you need any other refill" gets us shut out. Ask specifically about the name
When done covering all medications listed in rtm what question should you ask next?
Where would you look to see if we have received medications back from the provider?
Mail Order Tab , Mbrs Prescriptions
What pieces of information do you need to verify inbound calls?
Name/Dob/Zip
What type of plan covers diabetic supplies?
MAPD , MA
What pieces of information are needed to recap an order?
Recap the Order by confirming Name & strength of medication being refilled and/or placed on Auto Refill program; confirm the complete shipping address (2nd time) on the “Create Order Screen.”
What is the full absolute yes question?
May i have your permission to fax the provider, fill the requested items through Centerwell pharm and if nec request prescription from local pharm
Where do we check to see if a member has a balance?
Mail Order Tab > Demographics > Balance Due
What is the name for forcing someone to enroll?
Steering
No. We should be asking ourselves did we learn something outside of business needs. AKA
7-10 from docs response for new or renews
7-10 for NEW RX
5-7 for Refills
What disclaimer needs to be read before the absolute yes?
The Network Disclaimer
What is the dispo for a member who we just sent a new fax in rtm only ?
RTM BPO > Mbr Accept
If you miss any verbatim during the process this means you would pass or fail your call?
Fail
What are ways we can make a mbrs call above and beyond?
Using their name
Bringing an upbeat inviting tone
Being polite
Answering all their questions and concerns
Follow up with a mbr whose truly concerned about their meds. Show we care.
How much is expedited shipping?
6.99$ at members expense unless given permission from TL