Category 1
Category 2
Category 3
Category 4
Category 5
100
Do we fill Accredo specialty medications?
No Transfer Accredo specialty medication refill requests to Specialty Care Services
100
what ways can a member place an order for a refill
- IVRU/phone
- Scheduled (pending)
- Web
100
Can we use the Card# as listed in CSP as part of the authentication process
No (do not use the Card# as listed in CSP)
100
What is the close-ended statement.
If there's nothing else, please stay on the line to participate in a brief survey. Thank you for calling.
100
In CSP under what tab allows you to change the address for the member
Click on Profile
200
For a Deceased Patient Do We Handle the call
No Transfer to an Experience PCA
200
What are PCT hours of operation?
PCT hours of operation are 7 am - 7:45 pm, CT, 7 days a week.
200
Caller refuses to speak to a PC RPh What is the rad code
Question 2
What is the Required statement on Every Call we Must Ask the Patient
91.60.14
Do You Have Enough Medication on Hand
200
For Abusive Caller What is the scripting
Scripting: <Caller's name> it is important that this situation is resolved today. I can continue to help you and request that you please refrain from using abusive language, or I would be happy to connect you to someone who will be able to assist you further.
How would you like to proceed?
200
What are the caller types that you can speak to ANY PHI on the account once you authenticated?
•Patient, Parent, Designated Caregiver(Personal rep)
300
When a caller refuses to give a last name such as prescriber office or benefits office what much you do as PCA agents
accept a last initial in place of a last name.
300
What does Consent required on order status mean?
Prescriptions that require consent before the medication is sent out
300
When You see this icon and the member has additional questions regarding their medication who you would transfer
Transfer the caller to the Patient Formulary Education Department (PFED) during the hours of operation of Monday through Friday, 9 am to 5:30 pm ET.
300
The authorization limit can be adjusted between?
$100-1000
300
What is the Required scripting for rx sent by mail if rx is not found in the system:
Required scripting for rx sent by mail if rx is not found in the system: <caller's last name>, I know that having your medication is important. I am looking at your account. As of today, there is no record of receiving your prescription. It can take up to 7 days to receive your prescription. I am going to check the options available, to take care of you.
400
For a non-patient (spouse/partner Non listed Caregiver, family member, neighbor, broker, etc.) what medication information we can provide to the member
Only the medication that the caller has shown prior knowledge of
400
What do I do when an order shows Drug Under Review?
Review the account notes to check for the medication name. If not found, contact PCT using Guide Me. But we must Assist the caller with all other inquiries or issues before contacting the PCT
400
For Large Print Labels or Braille Request Who Would You Call
Contact PCT.
400
Do not open the PAD screen when:
The caller is not the member, patient, parent, or legal Guardian of a dependent child under the age of 18, and personal representative calls.
400
What Information is included on the Literature) Pack Name 3
Invoice
Total Amount Due
Medication Name /Information
500
Mandatory Transfers for a counseling PC RPh When
Accuracy of prescription
Allergy and health condition updates.
Medication does not belong to the patient.
Side effects leading to a medication being stopped.
Specific manufacturer or NDC product number requested (brand or generic).
500
As a PCA when submitting a renewal request to the prescriber if the prescriber does not response by day 21 what happens next?
the request is canceled. A communication is sent to the patient telling them the prescriber did not respond to the request.
500
When You Offer a PC RPh for counseling what is the required statement
Would you like to speak with a pharmacist about the impact of going without your medication?
The pharmacist cannot rush your order (PA). They can give helpful information about the effects of going without your medication.
500
What is the scripting when offering STS
I recommend that you get a short-term supply from a local pharmacy.
You are going to need a new prescription from your prescriber. Take it to the pharmacy and pay the copayment for your prescription.
You may get up to the base day supply of your medication.
500
When Searching for a patient in CSP Name 4 different ways you can search for the information?
First & Last Name
DOB
Zip Code
Member Id Or Member Phone Number
RX Number