General Inquiry
Notes & Attachments
Where the call is documented in the case.
Only available for unopened, unused vials that were provided by BMSPAF for a patient who is no longer on therapy & will not need any more product.
Reallocation
Required residency for LIS eligibility
The copay/cost share amount a Patient with Part D will pay in 2024 until they hit the "cap".
What is 25%
Outpatient/Inpatient Status
Shipping Information
NPI # or Physician State License #
What information can be obtained verbally from the HCP?
The resource we use for the format to create the note
The BMSPAF Tool Kit
Must be submitted via the TechBox/Escalation feature on the SharePoint.
Urgent Shipment Request
LIS Patient is Denied, but may ______ under what circumstances?
Patient's Payer has denied coverage of the medication AND the Patient submits a copy of the insurance payer denial letter of the medication
The maximum OOP a Part D Patient will pay for their prescription drugs in 2024.
$3,300
True or False: BMSPAF will accept a prescription written by a HCP other than the one listed on the Patient's application as long as the HCP is in the same practice as the Patient's listed HCP.
FALSE - All prescriptions received must be signed by the HCP listed on the Patient's application.
General Program Inquiry; Request for Information; Potential Adverse Event
What are the 3 acceptable case sub-type selections?
Where we are able to view all patient shipments/fills.
Related Brand tab under Fills
Patient appears to be eligibile for the LIS/Extra Help program, but is denied. Why?
Low-Income Subsidy Requirement Missing
All hematology/oncology renewals must submit the application here first
What is Access Support
A Patient may leave the income information on the application blank under what circumstances?
The patient submits a Federal Tax Return with the application.
3 - 5 Business Days
What is the turn around time (TAT) for processing or shipment of medication? (either is acceptable)
The Patient must have this many days of medication on hand (or less) before we can send to have processing be expedited.
3 days or less
Patients must have this category of insurance in order to be subject to LIS/Extra Help program requirements
Medicare
From where the Patient can obtain proof of LIS
Social Security Administration
You have an e-sign Rx; what two pieces of information must be on it?
What is DEA # and NPI # for the HCP.
We are not permitted to proactively advise callers of this option.
Appeal
When a Part D medication is Lost/Stolen/Damaged/Defective, we do these two (2) actions.
What is Warm transfer to Theracom to make determination on reshipment and Report AE/PQC
What is Federal Poverty Guidelines
True or False: Only Patients who are currently enrolled in a Part D insurance are subject to the BMSPAF LIS eligibility requirement.
False. ALL Patients who have Medicare are required to submit proof of LIS/Extra Help program denial (or approval).
If the Alternate Contact is not listed on the application, an MI case needs to be created to obtain the information: True or False?
False