SFDC1
The field that informs if a patient profile is Complete, Pending, or Close.
What is Patient Status?
The field that informs if a case is Pending, Complete, or Closed.
What is Case Status?
The question that determines whether or not the patient has additional coverage through a 3rd party Copay Assistance Program.
What is Maximizer Question?
The "soft cap" that patients will reach if they are flagged as a maximizer in the system.
What is 4k?
Our main target audience, the specific "bucket" of patients that this program is designed to assist.
What is Accumulator Patients?
The field that informs what was done or needs to be done in the patient profile.
What is Patient Sub-Status?
The section meant to house all information from your E1 check in a patient case.
What is Eligibility Information?
The third question the payer should be asked, that may determine we are sending the patient over to AAS.
What is PA on file?
The limit that every patient has that is the absolute most the savings card will pay out for a benefit period/year.
What is 14k?
The last thing you should be collecting on a call with a payer before disconnecting.
What is Reference Number?
The field that informs what type of plan the patient has, or possibly other findings based on a completed BI case.
What is Patient Outcome?
The section that should always be left blank if no further action is required in a task.
What is Due Date?
The limit that is only applicable to our program and covered medications if it is not specified to be only for smoking cessation or fertility.
What is MAB?
The tool used to calculate the benefit amount that the patient has utilized thus far this year and tells us what programs the patient may qualify for.
What is OPUS Calculator?
The first thing you should be disclosing on any call aside from your name and the reason for your call.
What is Call Recording Disclosure?
The section where you would see any tasks that are still pending action from an agent.
What is Open Activities?
The drop-down field in a patient case where we would document yes or no to the traditional question from our PBM call guide.
What is Does Copay apply to accumulators?
The question that can be cross-checked with a previous claim from OPUS to confirm if you are receiving up to date information from the representative.
What is Patient Responsibility?
The soft cap for all patients that are not flagged as a maximizer
What is 9,100?
The drug name for Humira
What is Adalimumab?
The patient profile section in which you would find the name of the PM you are going to assign your follow ups to.
What is Prescriber Information?
The three places where we should find your BI note taken and updated from ACSS Blizzard Notes Template.
What is Case Description, Case Notes, and Task Comments?
The question that determines whether or not the MOOP is applicable to the medication in question.
What is Is drug covered at 100% after MOOP is met?
The section in OPUS we should be looking in for calculating the benefits that have been used.
What is Total Benefit?
A red flag for pushback if a patient has used more from the TSC than their total MOOP limit.
What is Agent answered yes to traditional?