HIPAA
How can you obtain a patient's authorization ?
Enrollment Form ,Verbal Enrollment or Electronically by visiting e.lilly/taltzhipaa. or e.lilly/olumianthipaa.
In what ways can a Benefit Investigation Support be requested and who must request this type of support?
HCP can request a Lilly BV or Specialty Pharmacy Conducted ?
What are the type of benefit levels for the copay card and how much will the patient be responsible for paying?
Covered - As little as $5 a month
Non-Covered - As little as $25 a month
What program offerings does Eli Lilly offer to patient's ?
Commercial Copay , Injection Training , and Sharps Disposal Support
What must be stated on any Inbound Call and Outbound Call to a patient for both programs ?
I am calling from Taltz Together™ ixekizumab / Olumiant Together baricitinib . Our call is being monitored and recorded for quality and training purposes.
How long is a patient's authorization valid for ?
3 years unless a patient is a resident of Maryland , Maine or Montana in which case the patient authorization will last for 1 year
What information must be sent to the HCP once a Benefit Verification is complete and How is the patient informed of the Benefit Verification Outcome ?
Summary of Benefits is sent to the HCP and the Patient is informed via a Welcome Call
What Savings Card Eligibility must be confirmed before enrollment ?
1.Are you currently a resident of the United States or Puerto Rico?
2. Are you a Patient [or Authorized Representative] who is 18 years of age or older?
3. Are you enrolled in any government-funded prescription program? Examples include, but are not limited to, Medicaid, Medicare, Medicare Part D, Medigap, DoD, VA, TRICARE®/CHAMPUS, or any state patient or pharmaceutical assistance program.
If a patient is requesting Zep Bound , What must be confirmed and to whom will the patient speak with?
Program Representatives must verify that the Patient is enrolled in Taltz Together and has an HCP Enrollment Form on file with PA approval .
SWAT Team at 251- 1232
All calls must be ...
Logged to the related case , related brand ,and documented with a note on the patient's account
If we determine a patient does not have a valid HIPAA on file , What must be done on the patient's account ?
Patient copay savings card must be deactivated and if patient is filling with Sonexus a discontinuation fax must be sent
An email must be sent to TTOT management for Client review to advise of next steps
What information is given to the patient or Specialty Pharmacy when calling for Copay Card Details ?
RX ID , Group Number , Bin Number and PCN
Please list 7 case types you can see on a patient's account
General Inquiry , Welcome Call ,Benefit Verification ,Prior Authorization , Triage , AE/PQC , Document Review , Commercial Copay , Alternate Coverage , Order Tracking , Follow-Up 1 or Follow-Up 3
What does HIPAA stand for ?
Health Insurance Portability and Accountability Act
What is a TPA ? Can you name 4 ?
Third Party Administrator .
What does TLAC stand for and when do you transfer patient to TLAC ?
The Lilly Answer Center . To report a Potential Adverse Event ,Product Quality Complaint , or a medical inquiry that cannot be answered by reading verbatim from the medical and technical resource documents.
Please name all the types of enrollment forms the program will accept .
Taltz Dermatology , Taltz Rheumatology , Taltz Peds, Olumiant Dermatology and Olumiant Rheumatology