Quality Check
BV
PAP
Prescription/Triage
MISC
100

We will always have this in financial profiles

What is patient stated

100
New patient- reason for verification would be

What is upcoming treatment

100

No RTIP initials, what steps do we take

What is deny for RTIP consent

100

This is where the RX document is added to the triage

What is prescription doc

100

Patient is 67 we screen for

What is LIS

200

The alternate contact goes in what 2 places?

What is the person account and under patient contacts

200

We enter patient benefit information here

What is primary benefit profile

200

Patient is insured, this is the parent case to the PAP

What is BV

200

Meds need to be shipped to pt. We would send it through

What is Theracom

200

HHS is different on RTIP then pt stated. We would create this to balance it out

What is income doc profile

300

Patient has Part D coverage, we would enter it in benefits & coverage as

What is pharmacy benefits

300

Method of Completion should say what when calling out

What is phone call to payer

300

Patient is uninsured & approved. These are the 2 cases we will have

What is PAP and Triage

300

Shipping to MDO this is the Ship to Entity name

What is the providers name

300

Commercial payer states medication isn't covered. This is the blurb we fill out

What is AFP detailed BV blurb

400

Where the Patient signature date, initials, and provider signature are found

What is consents/opts/pref

400

Cost after deductible goes here in the bv

What is Medical Drug Copay/Coinsurance Value

400

This is where we find the eligibility dates on the related brand

What is Affordability

400

This is the Preferences Honored on the assign specialty pharmacy task

What is Manufacturer Preference

400

Alternate contact is missing phone number for commercial patient. This is

What is MI

500

This will be entered under each provider and each brand

What is provider site contact

500

Medicaid-patient med isn't on formulary. This is the BV outcome

What is not covered/specific exclusion

500

This must be answered on the 3rd task in the PAP before changing the status

What is the Medicaid question

500

If this isn't submitted, the medication wont go out

What is the fill

500

If HHS is missing from the application, we can obtain the HHS from

What is RTIP