Valeris Policy
True or False
You can use UTO hours BEFORE using PTO/Flex
False- all Flex and PTO must be exhausted
IF an HCP wants to have a PA tracked, how does the AC alert BVS?
Using the BVS Go SS.
If an HCP is OON on an SOB, what should the TAC do during CC?
Advise the HCP is OON and ask if there are alternate providers BVS can check.
How often should new documents and FRM communications be checked by the TAC?
True or False?
Agents cannot speak to an FRM about a patient if the FRM cannot provide the password only.
False- Agents CAN speak to FRMs without a password, but the FRM would have to provide 3 HIPAA items per patient.
True or False?
BVS should be checking provider preferences for additional information like TIN and alternative NPIs/facility NPIs.
True. BVS agents and TACs should be checking Provider preferences for anything that could assist the case
When should a case that has been triaged be closed by the TAC?
NEVER without permission. If a case is in triage, then SPL will be the ones to close the task and the case unless the TAC is directed otherwise by leadership or they received direct confirmation form the hcp the drug was delivered.
The HCP says they have everything they need and will send the rx themselves where it needs to go. What is the Case Closure Reason?
Hub_Process_Complete
No_Triage_Direct_to_SP
A DocuSign was sent to the patient. What is the password to open the document?
The patient's YEAR of Birth
Provide 2 ways you can get an occurrence
Clocking in late
Arriving/leaving without a 1 hour notice minimum
Clocking in from lunch late
True or False?
A patient HAS a copay accumulator on file, the copay card will go towards the OOPM.
FALSE- If there is an active Copay accumulator the copay card will NOT count towards the OOPM
What is the cadence for MI at intake?
BVS or intake sends a fax on day 1 to the HCP.(For pt signature, automatic Lifelynk text sent on day 1 and day 2) Day 3- call the HCP and Pt. Day 5- place an FRM note (if applicable, with pt signature on file). Day 7- call the HCP and Pt. Day 9- close case.
What is the difference between Hub Process Complete and Approved on Therapy Status
Hub Process complete - we have completed all tasks on our end but did not triage.
Approved on therapy should be used when we have confirmation of: Shipment, Delivery, or, injection of medication.
True or False?
Patient Nav can enroll a patient over the phone for any medication.
False. PN can only verbally enroll patients for injectables.
What patient case information CAN we send to an FRM or HCP in an email?
Case number only. No PHI can be included.
True or False?
An Rx was triaged to a SP 10 days ago with no update, should the TAC send an escalation to the SPL.
False. SPL escalations should be placed if there is no update for 3 weeks
What is the cadence for CCs for an office with NO SPOC?
Days 1, 3 and 5.
All contact attempts to an HCP have been exhausted with no success- what is the case closure?
Cancelled
No_MD_Response_for_Missing_Information
A patient calls in and says they need a provider in their area to get on medication. Should the AC transfer to Patient Nav or assist them on the call?
Current Processes say to transfer to Patient Navigation since they have more available resources to assist the patient.
How far in advance do you have to request PTO in DayForce?
At least 48 hours
MI was received on a case that was closed due to missing insurance cards. Should the agent alert the Region Chat or place the case on the BVS GO SS?
The agent should alert the region chat for any MI received.
What is the Cadence for CCs with a SPOC?
Within 24 hours of SOB creation- notate case that CC will occur on SPOC. Then CC will proceed with Meetings 1 and 2. If CC is not completed by end of meeting 2, close the case.
What are the 5 primary pieces of information needed for a Portal Escalation?
Callers name, Username, email, facility name, reason for the escalation.
If an AE is reported and has to be sent to Auditing to submit, what key information about the call should be in the subject line?
Date and Time of the call