Show:
Authentication
Hello Caller
Goodbye Caller
Who are you going to call?
RPH Calls
100

1.04.37

What is the SOP for Caller Authentication - Inbound, SOP 1.04.37 

100

2.1


Open The Call And Greet The Caller, SOP 2.1

100

2.16


what is Disconnected Caller, SOP 2.16

100

Solutions for when you don't know who to call.

what is the Contact and Transfer Quick Reference Guide Grid

100

2.3.1


SOP Clinical Inquiries and Access to a Pharmacist, SOP 2.3.1

200

When the caller cannot provide accurate or sufficient information to authenticate, you may speak to general information only such as:

  • Address to mail in prescriptions and EasyRx number
  • Balance due and the caller may make a payment
  • Medication coverage
  • Eligibility dates

  • General plan design

200

Scripting: This is (your name). May I help you?

What is the recommended greeting. 


200

What is rule #1?

Always end a call by making the caller feel valued.

200

Hospital pharmacy, ER or staff calling for medical record or history

PCT

200

What do we ask on every call? 

MOH

300

When all responses to the automated caller authentication questions match information in the system

What is IVRU authenticated

300

Scripting: I will be happy to provide you with my unique identification number which specifically identifies me. My identification number is <insert your RACF ID number>.

what is "provide your last name or RACF ID when requested. 

300

Not Ready - 07 - Medical Breaks/Outbound.  

What is the aux code you should be in, to make an outbound call. 

300

Incorrect member on Card, Statement or Literature

RTL

300

Accuracy of a RX, medication list, healthcare provider's office request to stop a rx, tab ID

what is Call types transferred to PCT when open 

400

A person who: is entitled by law to act on behalf of the patient in making decisions related to the patient's health care.

What is Personal Representative 

400
  1. State the recommended greeting two times and pause between each time you state the greeting.
  2. Speak the following required scripting, when you do not hear a response:

    Scripting: I apologize, I cannot hear you. Please call back for further assistance.

What is Silence on the Line/ account does not populate

400

When the RTL connects, explain the reason for the escalation and alert the RTL that the caller disconnected prior to the transfer.

What is an escalated transfer

400

Law Enforcement(FBI/Law Enforcement(FBI/Police) Police)

PC RPH

400

Allergy, medication event, not my medication, side effects, specific manufacturer or NDC product request. 

what is Mandatory transfers for a counseling PC RPh 

500

What do I do if a caller advises that they are going to record our call?  

Advise the caller you do not wish to be recorded and respectfully ask the caller to cease recording.

Exception. This does not apply to business offices, that have automated call recording.

500

Will onnly request benefits and eligibility, and may:

  • Sound robotic

  • Answer questions in a way that doesn't make sense

What is AI EVA Robocall 

500

Use Guide Me option, Disconnected caller returning a call, Issue requiring PC RPh to contact a PC RPh.

Explain the purpose of the call and reason for contacting the PC RPh

What is Disconnected from both the caller and the PC RPh 

500

Escalated Order Status 

WeCare

500

Brand/generic differences, damaged medication, defective medication, directions, duplicate therapy alert etc. 

what is Calls requiring an offer of counseling by a PC RPh