Triage
Please confirm which Triage task the PSR/PAS will work in Fusion.
Review and Validate, Contact ship to entity, Assign to specialty pharmacy.
How will you know if you are on refill reminders?
An email thread will be sent with your name on it.
What cases should have a F/U 3 Step?
Renewal Reminder, Status of application, Refill Reminder, New RX Needed.
Which task will you work on PAP case?
First three task
List the 4 steps of creating an ACR Case?
Create ACR Case, Research Coverage Options,Communicate Options,Coverage Follow-Up
What must we check in order for fills to submit.
Dosage tab under third task check the box.
How many times do we reach out for refill reminder calls?
3
When would we open a F/U 3 step for Triage.
After working the third task.
Where you should you stop on PAP case for peer review?
Second task.
If we are referring a patient over to a foundation what should our case subtype be?
External Coverage Referral
What is the first thing we should check after completing the triage.
Make sure fills went over and in pending status.
How many days will we set the task out on the first task for the due date?
25 days.
F/u 3 step for status of application will be opened and assigned to who?
The CL after the Access Counselor makes the first call attempt.
You must rerun task and make corrections if you do not get all of your yes's?
Correct everything should be meet in order to enroll in PAP.
Program Alternative Coverage Options
PAP-(Patient Assistance Program)
Copay Card- Commercial Assistance Program)
Foundation- (Foundation Copay Program)
Which tab will you look for the tracking info?
5th task Confirm shipment.
How many pills should a patient have before calling on refill reminder case?
5 pills.
If f/u 3 step case is unsuccessful what would be next?
We would wait for the patient to reach out to us.
If PAP case stops for correspondence plan contact where would you go to fix this?
Benefits and coverage tab under the pharmacy plan.
If we are moving straight to PAP what should the case subtype be?
Alternative Coverage Research.
Will you ever change the status on the actual Triage case.
No the system will update the status as the case moves through the system.
If the F/U 3 Refill Reminder call is successful what would be the next steps?
Task successful, case completed successful, and create new Triage and F/u 3 step reminder.
Should your F/U 3 step be attached to another case?
Yes, depending on which f/u 3 step case it is.
what should you do if your PAP is denied for income meaning patient stated and or RTIP?
A second determination can be made if patient is willing to submit a w2/1040.
When working on External Referral ACR case task 1 what would you do?
Check the foundation's box, Referral reason, Addt. Funding.