Programs
The program that follows members that have been non-compliant over the past 1-2 years.
What is MASP? (Medication Adherence Support Program)
These types of questions should be asked to determine barriers.
What are assessment questions?
The languages that Optum RX can print the RX labels in.
What are English and Spanish?
The types of questions that should be asked to members to get the most information.
What are open ended questions?
The name of the phone system that we use for making outbound calls.
What is Genesys?
What is Late to refill?
The minimum number of outbound dials per day per agent.
What is 70?
The largest number of statin prescriptions, that we monitor, a member may be on at any one time.
What is 1?
This is an approach designed to help people find motivation to make a positive behavior changes.
What is motivational interviewing?
These are the programs you can use to access to POA/HIPAA information.
What is ICUE, GPS, and MIIMs?
This call goes out when 85% consumption has been reached.
What is refill reminder?
This is the amount of time that PTO requests should be submitted in advance.
What is 2 weeks?
The percentage that the pharmacy program covers for the HEDIS Star measures.
What is 19%?
The acronym that helps with service recovery?
What is A-HA?
The number that you press to get into member information in Rxclaim.
What is 5?
This clinical pharmacist program can identify potential drug therapy problems and help members better understand their medications.
What is MTMCMR?
This score is considered a needs improvement on an audit.
What is 85-89?
Members who have failed one or more of the same Medication Adherence metric in 2021, 2022, and 2023.
What is elevated risk member?
For members that speak a language other than English, this service will be used.
What is language line?
This is created when selecting a barrier in CPQ.
What is a Work Queue?
This program supports the CAHPS and HOS measures for improved Stars performance.
What is Patient Navigator?
This is the part of the script that gives us the helpful messaging part of the audit.
What is "I was calling today to ensure you are receiving the healthcare support you deserve and to assure that you have no issues or concerns with your medications. You deserve the best health care experience, and we can help you get it."
The number of days a fax will auto-delete in right fax.
What is 6 days?
This is what we do to show members that we care about them.
What is show empathy?
When a member is to be placed as a DNC, this section is edited in demographics.
What is the do not call section?