Specialty Medications
These drugs often require special handling, monitoring, and could be at high-cost.
What are specialty medications?
IF a PT wants to pay at retail, what are the steps to make sure that is on profile? (list in order)
What is - 1. navigate to the patient profile.
2. Select patient preferences tab.
3. Select edit
4. Update pay at retail radial to yes
5. Save
This program helps reduce patient out-of-pocket medication costs.
What is copay assistance?
This holiday commemorates the signing of the Declaration of Independence in 1776.
What is Independence Day (Fourth of July)?
Instead of waiting in line at a standard retail store, CVS Specialty can send medications directly to a patient via this method.
What is home delivery? Or Office?
This is the first step where a prescription is entered into the system
What is intake?
What is PSR's Action for DNF CODE 83?
What IS Schedule the Order and follow SOP to obtain/update insurance
SPRx will create an Edit Failure task
Dedicated users will work the task and ensure the new insurance is added. Once approved they will remove the DNF, process/adjs the claim and then apply the appropriate Action and Outcome
This government insurance is typically for patients over 65
What is Medicare?
This U.S. president made Thanksgiving a national holiday in 1863.
Who is Abraham Lincoln?
If patients need to refill prescriptions or check an order status on the go, they can utilize the CVS Specialty website or this digital equivalent.
What is the CVS Specialty mobile app?
This process involves contacting patients to ensure they continue therapy.
What is refill?
What Is PSR Action FOR DNF Code 96?
What Is Transfer call to the Account Solutions (Ext. 99567 )
This Team checks a patient’s insurance coverage before filling a prescription.
What is benefits verification?
This holiday honors the civil rights leader born on January 15, 1929.
What is Martin Luther King Jr. Day?
This exclusive phone line is dedicated to patients needing help with copays, payment processing, or navigating their prescription billing.
What is Account solutions/Billing Department?
What is the name of the team used to treat cancer PT.
What is oncology Team?
What Is The Voicemail Script For MDO?
What is Hello, this is <User’s First Name> calling from CVS Specialty <include department as needed> calling for <prescriber name> regarding (reason for call, for example: “Prior Authorization”) for <state and then spell the members first and last name>. Date of birth <member DOB>. Please give us a call back at (appropriate toll-free call back number and direct extension if needed) at your convenience. We are open (office hours). Once again, that is (repeat slower and provide appropriate toll-free call back number and direct extension if needed). Thank you and have a nice day!
This approval is often required by insurance before certain medications are filled.
What is prior authorization?
This federal holiday was originally known as Armistice Day and honors military veterans.
What is Veterans Day?
The team that handles patient therapies isn't just pharmacists; patients also communicate directly with this group of specially trained professionals.
What are nurses?
This biologic is commonly used to treat rheumatoid arthritis and starts with “H”.
What is Humira?
This 3 letter acronym describes the process of ensuring a prescription is accurate, clinically appropriate, and ready to be dispensed.
What is DUR (Drug Utilization Review)?
This is the specific 10-digit number assigned to healthcare providers that CVS Specialty uses to track who is submitting the PA criteria.
What is an NPI? (National Provider Identifier)
This U.S. holiday became a federal holiday in 2021, making it the newest federal holiday.
What is Juneteenth National Independence Day?
This foundational 1996 federal law ensures that CVS Specialty protects the privacy and security of a patient’s health information.
What is HIPAA?