CMM
This healthcare technology company acquired CoverMyMeds in 2017.
What is McKesson
An agent is struggling to locate a specific resource. This tool can be used in AMQ to help easily locate material.
What is Search?
This is the process of verifying a patient's insurance coverage and determining their out-of-pocket costs for a medication.
What is Benefit Investigation (BI)?
This section of ICMS includes the system entry of Insurance Status, Payer Type, Plan Type, and Policy ID.
What is Section 1: Plan Information?
This acronym stands for the approval process that may be required before an insurance plan will cover a medication.
What is Prior Authorization (PA)?
CoverMyMeds' mission focuses on helping patients get faster access to this.
What are prescribed medications (or medication access)
In AMQ, this section serves as a table of contents and provides access to resources ranging from Acceptable POI to Consent information.
What is the One Stop Shop?
When completing a BI, this Task Status should be selected in the pop-up window.
COMPLETE
This documentation is copied and pasted into ICMS using the approved template to summarize the details of a Benefit Investigation.
What is a BI Note?
This acronym stands for the income guideline used to determine eligibility for many patient assistance programs.
What is Federal Poverty Level (FPL)?
This common healthcare process is a core service supported by CoverMyMeds to help providers secure medication approvals.
What is Prior Authorization (PA)
This section within the One Stop Shop allows agents to view a list of Bayer medications and associated program information.
What is the Product Matrix (or Medications)?
US resident/US Territory, Income Guidelines, Insurance Guidelines
After all phases of a Benefit Investigation have been marked complete in ICMS, agents create this document summarizing the investigation results.
What is a Statement of Benefits (SOB)?
This Medicare program, also known as "Extra Help," assists eligible patients with limited income or resources in paying for prescription medications and related costs.
What is Low Income Subsidy (LIS)?
CoverMyMeds works with these three major healthcare groups to help improve patient access to therapy.
Who are providers, pharmacies, and pharmaceutical manufacturers
When an agent is unsure of the next step to take during a Benefit Investigation, they should consult these AMQ resources for guidance and process direction.
What are Benefit Investigation Training Materials or WI-OPS-3699?
Every Benefit Investigation should provide enough information to answer these three key questions regarding coverage, authorization requirements, and patient costs.
What are Drug Coverage, PA Requirement, and Patient Responsibility?
When entering the Effective Date Range in Section 2: Plan Coverage, agents should use this button or hyperlink to quickly populate the dates.
What is Use Current Year?
This acronym stands for the organization that manages prescription drug benefits for many health plans.
What is Pharmacy Benefit Manager (PBM)?
CoverMyMeds describes its purpose as helping people get the medications they need to live this kind of life.
What is "a healthier life" (or improving patients' health outcomes)
This work instruction outlines the process for reviewing and handling determination appeal requests for the Bayer US Patient Assistance Foundation (BUSPAF) program.
What is WI-OPS-3675; Appeals Process - BUSPAF?
Before contacting an insurance plan, agents should review these five pieces of information.
What is patient's full name, date of birth, provider, prescription, and insurance?
When obtaining a patient's deductible responsibility, agents must collect both the deductible amount and ________.
What is Deductible Amount Met?
This Medicare Part D acronym stands for the member's qualifying prescription drug expenses that count toward coverage thresholds.
What is True Out-of-Pocket (TrOOP)?