Plan Info
What is the renewal process?
What will be second push back
What is there phone Number?
For Humana what will be the policy type by default
Medicare
If the Deductible is not met. What phase of Medicare Part D coverage the patient should be currently in?
Deductible Phase
What is the limit for the Individual Deductible for Sanofi?
How many numbers are there in the BIN?
There will be 6 digits in the BIN.
When agent given you Copay and Co-insurance both, Which one will be consider?
Co-Insurance
"Agent gives deductible of $590 but LIS level 1, 2, 3, or Unknown (PLAN IS A MEDICARE PART D PLAN)"
"Earlier you confirmed this is a LIS Plan. LIS 1, 2 and 3 do not have deductibles. Can you double check that please?"
What if the plan is terminated ?what is the next question we need to ask?
Is there a current active plan on file?
If the agent is not able to answer that what phase is the member currently in? Then what next we need to do ?
We need to choose Unknow . As because we are not able to headset that question.
If the agent is not able to provide the mail order and retail pharmacy cost share then what next we need to to ask ?
Would you be able to provide me the general cost share structure for that.
If the PA status is Pending what is the next question we need to ask?
Is there an active one?
What is the full form of the PCN and BIN?
Processor Control Number.
Bank Identifications Number.
If the agent give you the copay $154.72 then what is the PB for that?
That sound like an estimate, can you provide me with the percentage.
If the agent in Deductible is meet and OOP is not meet. Then the member is in which phase?
Initial Phase.
Is there a preferred mail order pharmacy from where the drug can be obtained?
Can the patient use (xxxxx) for the mail order pharmacy
2000
when on call agent stated the drug is covered under medical benefits, what will we input?
Just GE the call by adding task note that "Medication is only covered through medical benefit".
For the Sanofi calls we are calling for what type of drug?
Part D.
When agent state that the patient is in initial stage but the deductible is not met yet, what will be the next push back
Just to confirm, the deductible has not been met yet. The patient should be in the deductible phase. Can you check that please?
For obtaining the Prior Authorization what are the 4 information we collect form the agent?
1.Department Name
2.Phone Number
3.Fax
4. Website