Eligibility
Patients who are being treated by a licensed U.S. healthcare provider on an outpatient basis.
Patients who have been prescribed an AbbVie medicine that is included in the program.
Patients who have limited or no health insurance coverage.
Patients who demonstrate qualifying financial need.
Patients who live in the United States or its territories.
What are eligibility requirements for the program?
In writing by the doctor
What is how can medication changes be made? Dose changes acceptable.
Medicare RX Logo
CMS number
Medicare Advantage typed on card
What are the ways to identify Med D insurance card?
ii tabs po q12h
What is 2 tabs by mouth every twelve hours?
Side effect or symptom after patient takes Abbvie medication.
What is an AE/Adverse Event?
400%
What is the percentage of FPL/FPL requirement for the program?
Call the HCP to verify or look up expiration date in Medical Lookup tool.
What is the correct process when license number shows expired in our system?
Results are found with a CMS number
What is what the system /salesforce/ BV shows when patient has Medicare D?
Med D patients who enrolls in 4th quarter will have their application expire on this date.
What is 12/31 of following year?
Compliant about the quality of the product.
What is a PQC/product quality complaint?
The doctor on has to provide one, but the patient should provide two on their section of the application.
What are signatures/signature &date?
DAILY DOUBLE
We check to see if he/she opted into FCRA/EIV and follow EIV procedure in the system when this happens.
What is how do we determine income when POI is not provided?
Type of letter only required for Imbruvica patients.
What is ICPAP denial letter?
We would put this in the system If a patient were taking Depakote 125mg 5 per day because its the correct bottle count.
What is 5?
My dog Sam ate my medication and is not feeling well.
What is not reportable?
LIS Denial Letter
What is required of patients with Medicare and are 150% or below FPL?
MUST submit prescription form with application in accordance with state laws, rules, and regulations
If medication is going to patient’s home, RX must have special NY format with barcode
Barcode is not required if going to prescriber’s office.
What are the rules for NY prescribers/NY Rxs?
DAILY DOUBLE
There is no definitive answer provided. Terms such as "May" or "May not" are used throughout.
What is a pre-decisional letter?
This dose of Lupron can be prescribed to both male and female.
What is 7.5 mg Depot?
Patient calls and during conversation advises you that she heard a rumor that Depakote killed people.
What is not reportable?
Wait a maximum of 90 days prior to expiration of current enrollment, both patient and HCP complete application in its entirety, and attach all necessary supporting documents
What is the process for Medicare re-enrollment?
We can provide a replacement/reimbursement for medications under this program.
What is critical care?
For Imbruvica, if a patient's insurance is Med A&B ONLY we should mark this in the system for ICPAP Denial receipt question
What is yes?
this type of order should only be used when there was a problem with the previous order created where we made an error (example - wrong strength or quantity). We would also use the same prescription as the previous order.
What is a correction order?
Patient calls in for a refill. During the conversation they state that they are going in for a checkup today because their hemoglobin has been low.
What is reportable?