Inbound Essentials: The Basics
To begin your day with inbound, this action must be taken in Talkdesk.
What is changing your status from Offline to Available?
This is the required time frame to "claim" or mark questions with a check mark.
What is 5 minutes?
This is the first step to take when a caller reports their medication was stolen or lost.
What is initiating a Part D override?
When you open a BvD case and notice an ICD code (diagnosis code) at the bottom, this is the next step you take.
What is entering the override in CCA?
These types of medications are categorized at a higher cost level, making them more expensive for members, and are more likely to cause members to enter the coverage gap or become non-adherent.
What are high-tier medications?
The purpose of this team is to assist Devoted members who return calls related to specific Pharmacy Guide requests.
What is the Pharmacy Guide Inbound Team?
When a member requests a prescription transfer, this is the first step they must take.
What is contacting their preferred pharmacy to request the transfer?
The team responsible for handling overrides for diabetic supplies and Part D controlled medications.
What is the pharmacy inbound team?
When you speak to a member who states he/she no longer needs the medication, this is the next step you take.
What is completing the outreach?
This acronym stands for Next Best Action.
What is NBA?
This 30-minute block per day is dedicated to reviewing and addressing tasks, responding to inquiries, checking for updates, and following up as needed.
What is a dedicated 30-minute block for completing work from buckets?
When you're unsure of an answer, this is where you should search for help.
What is the Orinoco knowledge base?
This document must be updated after completing a manual override.
What is the Manual Override Spreadsheet?
When the provider listed in the case states the member is not established at their facility, this is the action you take.
What is creating the PCP?
This was identified as the biggest barrier to success in the past, occurring every time the baton is passed to a different team.
What is heat loss?
These SMS cases are reassigned to Pharmacy Guide technicians by Digital Guides based on member responses to SMS messages initiated by technicians.
What are SMS escalation cases?
When clinical questions related to medications arise, this is the tag used to request additional help.
What is @rph?
Questions about this specific Medicare plan's monthly billed amounts should NOT be transferred to CVS/C.
What is the Medicare Prescription Payment Plan (MPPP)?
When there is an approved PA for medication in CCA, this is the next step you take.
What is contacting the member?
When you receive a transfer call from MSG regarding NBA, it's because the members eligible for the program have at least one of these.
What is an overdue refill need?
If a member has already been discharged or graduated, this is the correct course of action.
What is creating a new outreach to speak with the member, without reopening previously closed outreaches?
A member is calling back regarding a hypertension management outreach, this is the correct action to take.
What is transferring the member to MOS?
Overrides must be processed within this timeframe after the request is received.
What is the same day?
This action is taken when it is determined that a member needs medication, and additional information is required from their provider
What is sending a notification by fax to the member’s provider for additional information?
When you receive an NBA call, this is the action you take to document the call.
What is documenting the call in the notes of the opportunity outreach?