Refill/WISMO/RAMDOM
This is the only planet in our solar system that rotates clockwise on its axis.
What is Venus?
To ensure all the members issue is being resolved what should we do?
Suggested Scripting " Have i resolved all your questions or concerns today?"
CWPCC AND RXE Closing the ca;;
The member is tired of the automated calls we keep waking her up. should we continue to let those calls go out and disrupt her sleep? what should you do
No we should not that's not nice. We can offer to to set up DO NOT CALL LOOK UP.
What is the TAT for OTC?
5-7 Business Days from the day after the order was placed.
if The member owes More than $70 on their account how long do they have to pay?
What is 30 days?
The member order is on its way and its the wrong quantify what should you do?
Consult with leadership and jet2Holidsay to a pharmacy tech
What are the self service options we have available?
The Member is requesting a NEWRX. What should you always do?
Offer to Submit a fax request through RTM-Retail to Mail and ask if they would like to enroll any others.
The member is upset about our services and will be telling everyone about the bad service we offer here at CWP. what should you do?
Offer to submit a valid complaint through feedback Loop
When does an Order enter the Copay 250 Queue?
When there's a CC attached to the order but the order exceeds the $250, which requires the member approval. and can change that amount at anytime from $250
You are refilling an Rx and the member mentioned that the last time we sent her a green pill of the same Rx but prior it was blue. what should you do continue to fill the RX ?
No lol we should not but Jet2Holiday to a Pharmacy tech, but First we should always consult with leaders before calling clinical services
Mentor doc. CWPCC Clinical Services Transfer Guidelines
The caller would like to know what's the highest score on the survey that they should provide to you because you have done such a great Job. What should you do?
Thank the caller for the great words but unfortunately we are unable to influence the members score. The survey will explain the score when completing
Where on the systems can we check for the members OTC benefit.
CRML- Pharmacy tab- Pharmacy benefits & Authorizations-Benefits.
CRML Access benefit grid
RX NOVA call connect- Benefits/Eligibility- Medical Benefit
Where should we go the set up members communication preferences?
IN CRML or MY apps.
The credit Limits that applies to All accounts
What us $100?
The member has PDP plan-Prescription drug Plan and would like to order her diabetic supplies include Ozempic. Where should you proceed with the order ?
For PDP plan the member will need to contact their part B provider.
When closing a call what's the required script ?
Thank you for calling Centerwell Pharmacy. Its been a pleasure helping you today. We are always here to help?
A member is going on Vacation for 6 months and need their refills, what should you do?
Test the claim if the member is eligible for the vacation overrides and submit a workaround the member is eligible up to 6mths
A member that speaks a language we ae not trained to assist, what should we do?
If the order has a $0 copay what should you do and there's a past due bal of $560on their account?
We should always release the order because its $0 also we can confirm with the caller if they are aware of the bal also check notes in CRML & EPOST if they are on a PP-Payment Plan
Advised the caller the RX is being request is not apart of their formulary offer alt or they can do PA-Prior Auth if they accepts the PA Jet2Holiday to HCPR-Humana Clinical Pharmacy Review Team
We did not received the members NEWRX its been over 2 weeks. What should we do as apart of issue resolution ?
Offter to follow up with the caller, leave the case in progress and follow through by calling the member with updates.
A member stated that she thought the OTC Item she ordered could fit but when she got it, its nothing like what she imagines and would like a return and refund like now its unfair.
Unfortunately for OTC items we don't accept return nor refund. If the member chooses the item and thought it was something else there is not much we can do.
These tiny plastic or metal tubes found at the ends of shoelaces have this specific name.
What are aglets?
What options the member has if they cant afford their RX?
*Payment Plan
* Get a lesser Quantify
* MPPP-If they are eligible
*Cheaper alternatives