SPRX Navigaton
Where are the PT Demographics located?
Where can you find the Prudent status of a Pt?
What is: The PT Header
What are the items needed to add CPA?
What is:
-BIN
-PCN
-Mem ID
-Group #
-CPA Name
What is needed when adding a Pt insurance information?
What is:
What is the allowed seconds for dead air before it becomes a deduction?
What is: 10 seconds
How do you locate the task history on an account?
What is: The left hand navigation menu, click task history.
If a pt is labeled as Prudent=UC or Prudent=P what is needed to be done?
What is: Warm transfer pt to Prudent Rx
Where is the CPA excel located?
What is: The pharmacy reference page
What is MAJ?
What is a PT's medical plan (Part B)
What is the hold time limit?
What is: 2 mins
What are the two things that must be repeated twice during order scheduling?
What is: The medication name in full and the delivery address
What is the PrudentRx Insurance Sequence
What is:
What # should the pt CPA be ranked as in the insurance screen:
What is: #2
How to verify the PT eligibility?
What is: Access Check Eligibility via the left-hand navigation.
What is the proper greeting for Silverlink Calls? -- Must be read verbatim
What is: “This is <your name> from CVS Specialty calling about a prescription.” Ask to speak to the patient or their authorized representative. When the patient or their representative answers state “For the security and privacy of your prescription information, please verify the following…”
Where do you find the RX Quantity and DS if it is not listed during the order summary?
What is: Dispense Maintenance Screen
What are the 5 Prudent Patient Status Indicators
(double points if you can name all 5 meanings)
What is:
PrudentRx = E (Enrolled)
PrudentRx = P (Pending)
PrudentRx = UC (Unable to Contact)
PrudentRx = R (Refused)
No PrudentRx Indicator Listed = Member not eligible
What is the process for when a PT doesn't want to utilize CPA and pay OOP to meet deductible?
What is: Expire the CPA and rank self as secondary
What is Medicare Part D?
What is: The PT prescription drug coverage
What all MUST be included in the call summary?
What is:
Full medication name, medication strength, dosage, quantity, day supply, copay, shipping address, on/by, delivery date, signature required
Where do you locate the callers intent?
Name the 5 Rejections a you should contact CPA to confirm if funds are exhausted
What is:
-Copay Threshold Exceeded
-Plan Limitations Exceeded
-Patient is enrolled in a maximizer plan
-System host error
-If the pt states they have already called CPA and was told we need to call
What plan does not allow for CPA?
What is: Government assistance plan; ie Medicare/Medicaid
What does Pharmacy Participation Not Established mean?
What is: Pharmacy not in network
What information is needed to fully authenticate a MDO call? (7 items)
What is: