Queue chart
If an order is in QMSI where is it at in the fill process?
Order is in process to be mailed out to PT
How many times do you need to say the callers name?
Once after confirming- you must do this for everyone that comes on the line
If a patient wanted to know about interactions on between two medications they are taking what department would we transfer the caller to?
clinical services
What system do you use to update member preferences?
CRM
320 is medicare- 319 is for commercial patient
The prescription is either expired or out of refills and we have either faxed or sent electronic request to provider for the patient
What should you do if the caller starts talking on the other line in the middle of us speaking?
We should always refrain from speaking over the caller and stop talking until they have completed their thought
If the patient wanted to add a new credit card to their account where would we transfer them to?
customer service
What system do you use to send someone a new consent form to update consent on file?
RX lookup
What number do you place in the INGR COST field when running a price quote?
9's
What does it mean when an order is in the "Pending CMM" queue?
The prescription is needing a prior authorization
Three minutes
If the patient has questions about their OTC benefits where would we transfer them to?
OTC department
What information MAY NOT be relayed on a call by a clerk?
Directions
What number do you place in the Rx Origin field when running a price quote?
1
If an order is in clarification outreach and a patient has questions about what we are needing to clarify what should you do?
We would want to advise the patient that we are waiting to hear back from the provider to clarify the prescription and if they have further questions from there we would warm transfer to clinical services department
5 minutes
What is the only department that we can cold transfer callers to even after fully authenticating?
Prior authorization department
Where can you look in ePostRx to find the NDC for a medication and the current manufacturer that we carry?
Product setup- product settings and search by product name/ alias
OR
Product setup- inventory product and search by product name/ alias
If a claim is denied what "bubble" do you click into to find the denial reason?
Errors
What does it mean if a prescription is in the inventory allocation queue?
Rx may be in back order, discontinued or NDC change and if the medication cannot be obtained within 5 days, the prescription will be RTP'd
If someone does not have consent on file for the member what are other ways we can gain consent to speak with them on the members behalf?
verbal consent if the member is available or implied consent
What is our NPI number for the pharmacy?
OH NPI# 1063675684
What POA type is not acceptable to release information to caller?
While the U POA is permitted to make address changes and address verification, no other piece of PHI has been approved to be released. U type POA may not obtain PHI on the member. This stance reflects the company's effort to adhere to both Medicare and HIPAA regulations.
Once a price quote is ran what "bubble" can you click into to see what tier level a medication is on?
Benefit