CAS
This is what we always ask for when getting a call to identify who is calling.
What is caller's name and title?
Submit this template if you encounter an error from another rep.
What is error reporting template?
This is what "e" stands for in ePA.
What is electronic?
You call this line if you need help with basic process questions.
What is Assist Line?
We transfer to this department for non-specialty new prescriptions (rxs).
What is Fast Start or Caremark New Rx?
This is what we open to RESEARCH in CAS on EVERY single call/fax/ePA.
What is PA History?
This is the template to submit if you keeping getting an error pop-up in CAS.
What is CAS error?
We always check _________ upon opening ePAs.
What is Drug Name, MDO format, overseas address, plan option, PA History?
MDO is checking on the status and is upset with how long this is taking to process and wants to speak to your supervisor.
What is Escalation/Appeal Line?
Costco Pharmacy is having issues with a claim. Record is set correctly. We transfer to this department.
What is Retail Pharmacy Help Desk?
We set _(#)__ records for Restasis.
What is two?
This is the template to submit if you suspect the caller is fraudulent.
What is MQA?
We must check ____ BEFORE exiting the patient account completely in Pending Approval Queue to ensure no duplicate PA records on file.
What is System Service (SS) record(s)?
MDO is calling to change their contact phone number for the appeal currently pending.
What is Escalation/Appeal Line?
The patient is needing a refill for their shipment for a non-specialty medication. PA is set and on file correctly. We transfer to this department.
What is CVS Caremark Mail Order?
We check these areas for URGENTS when processing PA faxes.
What is cover page, all of PA form, and 1st page of med recs?
This is the template to submit if you report an error by another rep and the wrong communication was sent to MDO/patient.
What is Manual Letter?
We find MDO answered 4000 per 90 days. We must do this after finding 4qty/90ds in claims.
What is Re-answering protocols and notate changed protocols?
The caller advises they need a PA for Carefirst. Contact this support line.
What is Medical PA?
Member needs a new prescription for a specialty medication. We transfer to this department.
What is CVS Specialty?
This is the outcome we select if we receive an up to date form that is missing all MDO information.
What is Incomplete Info?
You find an appeal in process and now have an approval for the medication. You must send this template.
What is Stop Appeal Due to New Info?
If protocols are missing in ePA, we select this outcome.
What is ePA Unable to Approve/Deny - Send Response?
Doctor is escalating due to the lab level being .5 off of the approvable lab level. We need to contact this line to get further assistance.
What RPh?
The MDO has an approval on file but wants to check how much the medication will cost for the patient. You will transfer to this department.
What is CSU (retail or mail)?