PHARMACY CULTURE
THIS SOFT SKILL ALLOWS PRIME RX REPS THE ABILITY TO RELATE TO WHAT A POTENTIAL CALLER MAY BE EXPERIENCING
WHAT IS EMPATHY?
THIS MAKES SEARCHING THE BET MUCH SIMPLER
WHAT IS USING CTRL+F?
THIS IS THE PRIME ENVIRONMENT CSRS WILL USE FOR ALL PHARMACY CALLS
WHAT IS RX3?
THESE ARE 3 OF THE REASONS CSRs USE MYPRIME.COM
WHAT ARE FORMULARIES, RUNNING TRIAL ESTIMATES, LOCATING IN-NETWORK PHARMACIES & ACCESSING PHARMACY FORMS?
THESE TYPES OF MEDICATIONS ARE USED TO TREAT & STABILIZE LONG-TERM MEDICAL CONDITIONS WITH NO CURE.
WHAT ARE MAINTENANCE MEDICATIONS?
THIS FILLS IN THE BLANKS FOR "ALL ____ ARE NOT __________ BUT ALL _________ ARE __________"
WHAT ARE DRUGS AND PRESCRIPTIONS?
THIS PRIME PROGRAM ALLOWS MEMBERS TO FILL UP TO A 90 DAY SUPPLY OF A MEDICATION AT A RETAIL PHARMACY, WITHOUT HAVING TO USE THEIR MAIL ORDER BENEFITS.
WHAT IS THE EXTENDED SUPPLY NETWORK?
FOR NOW, CSRS CAN LOCATE THE BET DOCUMENTS IN THESE 2 PLACES
WHAT IS THE MS TEAMS HCSC - PRIME -BET CHANNEL/FOLDER OR THE SHARED FOLDER?
THIS F KEY WILL TAKE A CSR BACK TO THE PREVIOUS SCREEN VIEWED
WHAT IS F12?
THESE TYPES OF MEDICATIONS ARE STORED, HANDLED AND SHIPPED DIFFERENTLY THAN NORMAL MEDICATIONS
WHAT ARE SPECIALTY MEDICATIONS?
THIS PROCESS IS USED WHEN CSRS NEED ASSISTANCE WITH RX OVERRIDES OR OUTREACH TO PRIME RX HELPDESK
WHAT IS THE PHONE A FRIEND PROCESS?
THIS BENEFIT DESIGN REQUIRES MAINTENANCE MEDICATIONS BE FILLED AS A 90-DAY SUPPLY EITHER WITH MAIL ORDER OR EXTENDED SUPPLY NETWORK PHARMACIES.
WHAT IS 90DAYMYWAY?
THIS IS THE FIRST SECTION OF THE BET THAT CSRS SHOULD REVIEW WHEN OPENING THE DOCUMENT
WHAT IS THE ACCUMULATOR SECTION?
THESE SINGLE LETTER CODES IN PRIME RX ALERT CSRS TO CLAIMS ON FILE, AUTHORIZATIONS ON FILE & CALL TRACKING NOTES
WHAT ARE REVERSE VIDEO INDICATORS (RVI)?
OTHER THAN THE DRUG FORMULARY, THIS LIST CAN BE USED AS REFERENCE FOR MEDICATIONS COVERED UNDER THE PHARMACY VS MEDICAL PLAN.
WHAT IS THE SPECIALTY DRUG LIST?
THERE CAN BE UP TO SIX (6) DIFFERENT TYPES OF THESE IN A PHARMACY PLAN, WHICH HELP IDENTIFY THE PRICING STRUCTURE OF A MEDICATION
WHAT ARE TIERS?
THIS FORM OF UTILIZATION MANAGEMENT REQUIRES THE TRIAL AND FAILURE OF A FIRST-LINE DRUG BEFORE A SECOND-DRUG LINE WILL BE APPROVED
WHAT IS STEP THERAPY?
THESE ARE THE STANDARD HOME DELIVERY PHARMACY & SPECIALTY PHARMACY COMPANIES
WHO/WHAT ARE EXPRESS SCRIPTS (ESI) & ACCREDO?
YOU WOULD GO TO THIS SECTION OF THE BET WHEN ADDITONAL INFORMATION IS NEEDED ON A COVERED PHARMACY BENEFIT.
WHAT IS THE BET ADDENDUM?
THESE FIELDS ARE CHANGED TO 9999.99 WHEN RUNNING TRIAL CLAIMS IN PRIME RX
WHAT ARE COST, DUE & UC/W FIELDS?
ASIDE FROM THE FORMULARY, THESE ARE 2 FORMS CSRS MAY NEED TO FAX TO A PROVIDER
WHAT ARE DISPENSING LIMIT FORMS - PRIOR AUTHORIZATION FORMS - STEP THERAPY FORMS - COVERAGE EXCEPTION FORMS - MPTD FORMS - HIGH DOLLAR CLAIM FORMS - ACA COPAY WAIVER FORMS?
WHEN A PLAN HAS _____ & ____ PHARMACIES, BOTH ARE CONSIDERED TO BE IN-NETWORK, BUT ONE HAS A CHEAPER COPAY/COINSURANCE THAN THE OTHER
WHAT ARE PREFERRED & NON PREFERRED PHARMACY?
THIS A SCHEDULED CONVERSATION BETWEEN THE REQUESTING PHYSICIAN AND A PHYSICIAN REVIEWER AFTER AN AUTHORIZATION REQUEST IS DENIED AT PRIME
WHAT IS PEER-TO-PEER?
THIS PROGRAM'S PURPOSE IS TO MAXIMIZE THE COST OF SPECIALTY MEDICATIONS TO UTILIZE THE ENTIRETY OF A MANUFACTURER ASSISTANCE PROGRAM.
WHAT IS THE FLEX ACCESS PROGRAM (STANDARD)?
CSRS CAN CHECK THESE 2 PLACES IN THE BET FOR CONTRACEPTIVE COVERAGE
WHAT ARE PPACA AND CONTRACEPTIVES?
THIS IS THE CODE CSRS MUST TYPE IN THE MEMBER DETAIL LIST SCREEN TO VIEW MEMBER ACCUMULATORS
WHAT IS 19?
THIS IS A PROGRAM THAT ENSURES MEDICATIONS ARE BEING TAKEN AS PRESCRIBED AND THAT CERTAIN MEDICATIONS ARE CLINICALLY REVIEWED
WHAT IS UTILIZATION MANAGEMENT?
DOUBLE JEOPARDY!!!!
WHAT ARE BACK ON TRACK (BoT) OVERRIDES?