Do I Divert?
YOU GET AN APRETUDE OR CABENUVA RX FOR BOTH A LOADING AND MAINTENANCE DOSE. WHEN YOU CHECK THE PT RX PROFILE YOU SEE THAT A MAINTENANCE DOSE HAS ALREADY BEEN SHIPPED. DO YOU DIVERT TO CLARIFY DIRECTIONS?
YES. "DO NOT ENTER CABENUVA/APRETUDE LOADING DOSE IF PATIENT HAS BEEN ON MAINTENANCE." - DIRECT QUOTE FROM COE TEAM MEETING NOTES 09/18/2024
YOU RECEIVE AN ENTRY TASK FOR ILARIS. YOU NOTICE THERE IS AN ILARIS TASK IN CLARIFY AS WELL. THE NEW ILARIS RX ALSO NEEDS CLARIFICATION. SINCE THERE'S ALREADY AN ILARIS TASK IN CLARIFICATIONS - WHAT DO YOU DO?
CANCEL THE ORIGINAL ILARIS CLARIFICATION TASK AND RESTART CLARIFICATION CADENCE ON THE NEW ILARIS RX.
>> MULTIPLE TEAMS POSTS FROM LEADERSHIP
WHEN THE TARGET DATE IS RED, WHAT ACTION DO YOU TAKE REGARDLESS OF WHETHER IT'S ATTEMPT 1, 2, OR 3?
CALL - WE ALWAYS CALL WHEN THE TARGET DATE IS RED
TEAM INFO>> JOB AIDS>> PRESCRIBER ENGAGEMENT
YOU RECEIVE AN OPEN RESPONSE TASK FOR DROXIDOPA. YOU NOTICE THERE IS A DIVERTED DROXIDOPA RX ALREADY ON THE PATIENT PROFILE. BESIDES ENTERING THE NEW RX, WHAT ELSE DO YOU NEED TO DO BEFORE GOING TO THE NEXT TASK?
CANCEL THE CLARIFICATION TASK
>>MULTIPLE POSTING IN TEAMS FROM LEADERSHIP
IT'S COMPLETELY OPTIONAL TO ENTER THINGS SUCH AS DIAGNOSIS CODES, WEIGHT/HEIGHT, ALLERGIES, AND CONCURRENT MEDICATIONS, ESPECIALLY WHEN YOU'RE JUST DIVERTING THE RX. TRUE OR FALSE?
FALSE, WE SHOULD ALWAYS ENTER THOSE THINGS, EVEN IF YOU'RE JUST DIVERTING THE RX.
-PER MULTIPLE TEAMS POSTINGS FROM LEADERSHIP
YOU GET AN APOKYN RX WITH THE FOLLOWING DIRECTIONS: INJECT 0.6ML UNDER THE SKIN 5 TIMES A DAY, QTY IS 126ML WITH 3 REFILLS. WHAT DO YOU NEED TO DO IN ORDER TO ENTER THE RX? WHAT IS THE DS AND HOW MANY PEN NEEDLES AND ALCOHOL SWABS DO YOU ENTER? OR DO YOU DIVERT FOR QTY?
YOU DO NOT DIVERT. USE THE APOKYN CALCULATOR. THE DS IS 32. YOU CALCULATE THE # OF PEN NEEDLES/SWABS BY MULTIPLYING THE # OF INJECTIONS PER DAY BY THE DS (EG: 5 X 32 = 160 PEN NEEDLES) THEN ON THE SWABS YOU ROUND UP TO THE NEAREST 30 (EG: 180 SWABS).
- TEAM MEETING WITH TARA
YOU ARE WORKING A TASK AND WHEN YOU CALL THE MDO PHONE NUMBER ON THE RX YOU GET AN OUTBOUND MESSAGE THAT SAYS, "THE PHONE NUMBER YOU'VE DIALED IS NO LONGER IN SERVICE" OR SOMEONE ANSWERS BUT SAYS, YOU HAVE THE WRONG NUMBER/THAT PRESCRIBER NO LONGER WORKS THERE, ETC - WHAT DO YOU DO?
FOR PE AND CLARIFICATIONS: YOU FIND AN ALTERNATE PHONE NUMBER BY CHECKING (1) LEXIS-NEXIS, (2) PAST RX'S, (3) GOOGLE SEARCH. IF THESE THREE THINGS FAIL TO RESULT IN A WORKING PHONE NUMBER AFTER YOU'VE TRIED CALLING THEM, THEN YOU SET A CONTACT PATIENT TASK FOR SAME-DAY CONTACT TO GET NEW MDO INFO AND PUSH THE TASK OUT FOR TWO DAYS WITH A NOTE THAT WE ARE WAITING ON PT CONTACT FOR A NEW MDO PH# & THE PHONE NUMBER ALTERNATES YOU TRIED.
MULTIPLE TEAM MEETINGS, TEAMS POSTS FROM LEADERSHIP, AND ONE NOTE
WHEN WE NEED A RX FOR A CIT HOME INFUSION MEDICATION, AND THE DOCTOR IS IN NY, WHAT ACTION DO WE TAKE REGARDLESS OF IF IT'S ATTEMPT 1, 2, OR 3?
WE CALL - SINCE IT'S A NY PRESCRIBER, WE CALL BECAUSE WE NEED VERBAL NURSING ORDERS.
TEAM INFO >> JOB AIDS >> PRESCRIBER ENGAGEMENT
WHAT 3 THINGS DO YOU HAVE TO DO WHEN THE ORDER IS MARKED "RUSH", "URGENT", "ASAP", OR FOR NEXT DAY DELIVERY REQUESTS?
1. ENTER A NOTE IN GEN NOTES THAT SAYS, "RX#123456, RECEIVED ON 01/01/1001, STATED "RUSH/URGENT" - ESCALATION TASK REQUESTED
2. COPY AND PASTE THAT NOTE WHEN CREATING A CONTACT PATIENT TASK - MAKE SURE TO TIE THE TASK TO THE RX IN QUESTION!
3. EMAIL THE APPROPRIATE TEAM FOR THAT DRUG WITH SCREENSHOTS OF THE PT INFO SECTION+RX# AND THE COMMENT(S) FOUND ON THE RX THAT INDICATE IT'S A RUSH ORDER; AND CC BOTH ANGELA AND TARA ON THE EMAIL
TEAM INFO>> JOB AIDS/FORMS>> URGENT TASKS
BRIXADI CANNOT BE ENTERED UNDER THIS BU?
LENEXA
MULTIPLE TEAMS MESSAGES AND TEAM MEETINGS AS WELL AS IN ONE NOTE,
MISC. COE'S>> SUD/SUBSTANCE ABUSE>> BRIXADI
YOU ARE ENTERING A NEW PRESCRIPTION AND NOTICE THAT THE PRESCRIBER SIGNED ON BOTH THE DISPENSE AS WRITTEN LINE AS WELL AS THE SUBSTITUTION PERMISSIBLE LINE. WHAT DO YOU DO?
YOU WOULD DIVERT TO CLARIFY UNLESS THE RX IS FOR MIRENA OR ANOTHER IUD, REGARDLESS OF WHETHER THE DRUG IS AVAILABLE ONLY AS BRAND.
THE SOURCE>> ENTRY WORK INSTRUCTIONS
YOU COME ACROSS A CLARIFICATION TASK THAT SAYS IT'S A COMPANION RX. WHAT'S THE 2 THINGS YOU SHOULD DO NEXT BEFORE EXITING THE TASK OR PUSHING IT OUT?
CHECK TO SEE IF IT'S AN ACTUAL COMPANION RX. IN OTHER WORDS, IS THERE A SECOND RX IN CLARIFICATIONS WITH IT? WE SHOULD ALSO CHECK THE FAX SENT AND SEE IF THERE WAS A NOTE SENT TO THE DOCTOR'S OFFICE.
MULTIPLE TEAMS POSTS FROM LEADERSHIP
IT IS NOW OK TO USE SYSTEM FAX ACTION TO OBTAIN A NEW RX FOR CONTROLLED MEDICATIONS. TRUE OR FALSE?
FALSE, DO NOT USE THE SYSTEM FAX FOR CONTACT MD FOR NEW RX FOR CONTROLS
TEAM INFO>> JOB AIDS>> PRESCRIBER ENGAGEMENT
WHAT 3 SUPPLIES NEED DOUBLED FOR THE 1200MG SKYRIZI STARTER DOSE?
ONE NOTE: INFUSION CIT-RIT>> CIT SAC>> SKYRIZI, TEAM MEETING 09/18/2024
FOR THIS MEDICATION, YOU MUST EMAIL SRX-UTXINQUIRY@CVSHEALTH.COM AND RECEIVE CONFIRMATION FROM THEM THAT IT'S OK TO CANCEL THE RX BEFORE YOU'RE ALLOWED TO CANCEL IT. WHICH DRUG IS THIS?
DOJOLVI - DO NOT CANCEL FOR MAX ATTEMPTS UNLESS YOU EMAILED THEM AND THEY HAVE ADVISED YOU IT'S OK TO CANCEL.
- PER TEAMS POSTING FROM LEADERSHIP ON 10/01/2024 AND UNDER MISC. COE'S>> RARE DISEASE TEAM>> DOJOLVI
YOU ARE ENTERING A SUBLOCADE 100MG PFS RX AND THE PRESCRIBER WROTE FOR A QTY OF 3 EACH. WHAT DO YOU ENTER AS THE QTY AND DS?
YOU DON'T ENTER IT, YOU HAVE TO DIVERT IT BECAUSE CONTROLLED MEDS SUCH AS SUBLOCADE AND BRIXADI CAN ONLY BE DISPENSED AS A ONE-MONTH SUPPLY.
- ONE NOTE>> MISC COE'S>> SUD>> SUBLOCADE
FOR THIS STATE, ALL RX'S MUST BE AN ERX. FOR INFUSION DRUGS WE NEED BOTH AN ERX FOR THE MAIN DRUG AND ANY PREMEDS AS WELL AS FAXED OR VERBAL INFUSION ORDERS.
STATE OF IOWA
TEAM INFO>> JOB AIDS>> IOWA STATE PRESCRIPTIONS
YOU ARE WORKING A CONTACT MD TASK ON MONDAY, 09/16/2024. THERE IS A RED TARGET DATE OF 09/17/2024. YOU MAKE THE THIRD ATTEMPT AND IT'S SUCCESSFUL. WHAT 3 STEPS DO YOU TAKE NEXT?
(1) YOU DOCUMENT YOUR THIRD ATTEMPT AND (2) PUSH THE TASK OUT TWO DAYS FOR FOLLOW-UP (09/18/2024) AND (3) SEND THE PATIENT AN IMM FOR EITHER ORDER POSSIBLE DELAY OR NO CONTACT FROM MDO.
TEAM INFO>> JOB AIDS>> PRESCRIBER ENGAGEMENT
WHAT 9 SUPPLIES DO WE NOT ENTER FOR CORAM INFUSIONS?
WEEKLY UPDATES>> SOP UPDATES>> CORAM INFUSION SUPPLIES
& IN COE TEAM MEETING NOTES 08/21/2024
IF YOU RECEIVE AN OCREVUS NURSING ORDER FOR HOME OR CORAM INFUSION WITH THE FOLLOWING DIRECTIONS: "INFUSE 600MG IV EVERY 6 MONTHS." YOU SHOULD ENTER WHICH OF THE FOLLOWING DIRECTIONS:
(1) INFUSE 600MG IN 500ML 0.9% NS INTRAVENOUSLY AT 40ML\HR AND INCREASE BY 40ML\HR EVERY 30 MINUTES (MAX 200ML\HR) OVER AT LEAST 3.5HRS AS DIRECTED EVERY 6 MONTHS
(2) INFUSE 600MG INTRAVENOUSLY EVERY 6 MONTHS
OPTION 1.
"***PLEASE REMEMBER IF YOU ARE ENTERING INFUSION ORDERS FOR OCREVUS YOU MUST USE COMPLETE DIRECTIONS THAT INCLUDE INFUSION RATE// ALSO OCREVUS STATES UNDERNEATH INFUSION RATES "IF NO INFUSION RATE MARKED DEFAULT TO 3.5 HR STANDARD INFUSION**"
PER LEADERSHIP ON TEAMS ON 10/08/2024
YOU HAVE A DUOPA RX IN WHICH THE PRESCRIBER WROTE DOSES WITH RANGES, AND CHECKED UNPROGRAMMED PUMP WITH NO LOCK LEVELS. DO YOU DIVERT OR ENTER THE RX AS WRITTEN?
DIVERT - IF THERE ARE RANGES THEN LL1 SHOULD BE MARKED AND THE PUMP HAS TO BE PROGRAMMED.
MISC COE'S>> PARKINSON'S>> DUOPA: "IF MD MARKS NON-PROGRAMMED PUMP A LOCK LEVEL CANNOT BE CHECKED", THEREFORE THE PRESCENCE OF RANGES MEANS LL1 NEEDS TO BE CHECKED THEREFORE THE PUMP HAS TO BE PROGRAMMED
YOU ARE WORKING A PE OR CLARIFICATIONS TASK AND IT'S EITHER BEFORE 9AM OR AFTER 4PM IN THE LOCATION OF THE MDO. IT'S TOTALLY FINE TO NOT EVEN BOTHER CALLING AND PUSH THE TASK OUT DUE TO TIME ZONE DIFFERENCES. TRUE OR FALSE?
FALSE, YOU SHOULD AT LEAST MAKE AN ATTEMPT ON ANY TASKS PUSHED TO YOU AS THERE MAY BE SOMEONE THERE AND/OR AN ANSWERING SERVICE OR OTHER OPTION TO LVM. WE CANNOT ASSUME NO ONE IS THERE. IF THE TASK CAME FROM A LIST YOU SHOULD FOLLOW UP AT THE APPROPRIATE TIME RATHER THAN PUSHING IT OUT. DO NOT JUST PUSH OUT THE TASK FOR SOMEONE ELSE TO WORK LATER.
TEAM MEETING 10/30/2024
YOU HAVE A CONTACT MD FOR RENEWAL RX TASK AND YOU JUST MADE THE SECOND ATTEMPT. NO ORDER IS SCHEDULED. WHICH "ACTION" DO YOU CHOOSE?
ANSWER: CANCEL. "YOU CANCEL A CONTACT MD FOR RENEWAL RX WHEN YOU MAKE THE SECOND ATTEMPT UNLESS ORDER IS SCHEDULED FOR A FUTURE DATE."
DIRECT QUOTE FROM COE TEAM MEETING 09/18/2024 & ONE NOTE
ARE SPC IMAGES VALID FOR NY PRESCRIBERS?
YES, THEY ARE VALID
PER MULTIPLE TEAMS POSTS FROM LEADERSHIP
WHEN DOING A RE-WRITE FOR A 90DS WITH 3 REFILLS, ONCE DAILY RX WHERE WE ONLY DISPENSED A 30DS, HOW DO YOU FIGURE OUT THE REFILLS REMAINING.
THE REFILLS REMAINING WOULD BE THE QUANTITY REMAINING MINUS THE DISPENSE AMOUNT, THEN THAT NUMBER DIVIDED BY THE DISPNSE AMOUNT (WRITTEN FOR 90DS, 1 DAILY WITH 3 REFILLS, DISPENSED 30; QUANTITY REMAINING IS 330, SO TO FIGURE OUT REFILLS YOU WOULD DO 330-30=300, THEN 300/30=10 THEREFORE YOU ENTER 30 WITH 10 REFILLS.
- ONE NOTE>> MISC COE'S>> NDC CHANGE/RE-WRITES