STANDARDS
ISSUES/EXCEPTIONS
REFILLS
ORDER PROBLEM
JARGON Etc.
100
"Yes, umm my name is Arthur Douglas....errr I mean Drax the Destoyer now...I was created on 02/21/1973 but born on 01/19/1963"
-This is a FED LAW to always verify first to access or share Patient Information-
2.2 -
HIPAA Verification should be verified for access to all patient information
100
"Hello digital medicine people! I called because i was texted that our orders have some payment and because Terran medi...crarrr D part?, so the card says I have to say it's okay, so... it's okay?! we are like bounty hunters/galactic guardians. So we make allot of money...usually"
-Part of what PowerPoint?-
-This Issue Type is used because the process works the same as a High Co-Pay-
-Empowering Agents PowerPoint-
3.7.9-
This is a "Co-Pay/Eligibility"-ISSUE for
a SEO(MPD) exception release
100
"Hello citizen, Start Lord here , and yes you are welcome for everything we do, however as the captain I have decided to ensure my crew is ready before our next job, and so...I want to have everyone's medicines filled immediately...
What are the first things to confirm prior to refilling an Rx?
&
What are the things to confirm post order creation?
3.1.1- Refills
Review prescription information to ensure accuracy
Ask how much medication does the patient have on hand?
Confirm shipping method / Explain or upgrade if necessary
Have verified the full shipping Address
Confirm credit card on record
&
Provide the caller with a recap of the order created.
If order exception exists, educate the caller on the exception(s)
Quantity of Rx’s requested/ being shipped
Copay price of Rx or total order amount (when applicable)
100
"Hey there!, Drax here has been waitin forever now for his meds and is getting cranky now...where exactly is it, he's gonna start tearing up the ship soon!"
- This ENTIRE section tells us how to track order through our carriers-
-Who is our preferred carrier?
3.15 -
TRACK HOME DELIVERY ORDER SHIPMENT
We can follow sop through the carriers steps to obtain the shipments progress ( UPS, FedEx, and USPS )
and WAG prefers FedEx
100
"Okay so, i forgot that you guys don't do the whole interstellar delivery drones cheap...at all....but we are at a job right now, and then I'll have your money....can you make sure that it was cancelled for now..."
Order# Ent.Date Rec. Date Stat Route Split PrefShip
T8938BC 12/09/2019 12/09/2019 CAN N/A N Best Method
-What does this Abbreviation CAN Mean?-
CAN = Canceled - The order is CANCELED.
200
" Oh yea, um i recently found out....i am allergic to Racoon hair , and bark things...."
-Any agent asks for these updates before ending every call-
2.5.23 -
Confirm Allergies/Health Conditions of patient at the end of every call.
200
"I got a computer mail saying that you guys had the old address on file, and I want to change the address for Mantis's order of Junel...It's the Ship if that's okay...it moves sometimes"
- This section runs down how to update/change the shipping destination, and what type of ISSUE is created -
When is it too LATE? what do you do?
3.7.8-
Change Shipper/Address " ISSUE "
An Agent Creates the Issue above to update the order information unless it is already in STP status in which case you must contact helpdesk asap to resolve.
200
" Okay Mrs. Destroyer.... it looks like your order has not yet been shipped... cuz the charge of $101.01 did not go through...guess you guys have nothing to do... would wanna try a credit card or something till you get a job?"
" Oh yea, i forgot i got a new card! Here let me find it for you Mrs. Angry pants.... "
- This section of refills follows the steps to complete the payment of the current balance-
-What Issues are created?-
3.1.6-
Patient just has an outstanding balance
We need only to update/change the card information to process the order
We do not have to create an issue to pay a balance
200
"Sooo...an hour ago, one of your little drones with Drax's meds came by...But...I kinda overreacted since you guys don't mark them very well, like at all.You really should do something about that, but yea , i blew it up , thought it was a tiny guy whom I owe money...when can ya send another?
-This Section refers to handling procedures for damaged orders- What Issue do we create?
What can an agent offer?-What if some of it was cold pack?
3.6.1 -
Order was received damaged in some way ( and it is not the patient's fault....supposedly ours for not marking right )
If the order was damaged we create a DAMAGED issue only if the patient demands the meds replaced, we may instead offer a $50 compensation ( max )
Transfer any call regarding a cold packed item to a Pharmacist. If needed, they will create the ISSUE.
200
" Okay Mantis if you can find at least one copy of his meds that isn't burnt up , please tell me the any of the prescription information such as rx# ( etc. )...."
-What does this Abbreviation NDC mean -
NDC = National Drug Code - A group of numbers assigned to each drug to identify many components including package size, etc. Needed for proper insurance processing
300
"Oh hello, i was just wondering if my order was here yet?...oh wait one second, Thanos finally came...{ random noises and screams}...okay so I uh, kinda Batista bombed him into the box i had here...turns out it was the medicine...sooo never mind but thank you and you're welcome"
-You got a reduced score in your NiceReview
Marked for wrong dispo code chosen - "other"
-This action should be done as Part of every call-
2.4-
Call Disposition
You should always set call disposition before ending the call
Drax initally called for status update
300
" Drax is invisible again...he always does this... but he is speaking to me...It's like he's right next to me or in my head... he wants to ask if the Actiq Lollipops are supposed to make your teeth disappear for a couple minutes after biting them...."
- This section explains what an agent can handle, what one cannot, and who specific drug questions are sent to -
Can a technician who uses this medication explain the symptoms?
2.6.4 - xXxXxXNOPExXxXxXx
Any calls regarding information on drug interactions/reactions, errors, or worries are to be transferred to a HD Rph for consultation
and technicians are not to give any consultation information for medications no matter what
300
- "Hello this is Pharmacist Thanos of WAG store# 85031, and I have a Drax T. Destoryer here who would like to have his baby aspirin be delivered to his Space Vessel from now on."
-This section of fill has the steps you would follow to have a script filled from retail through H.D.-
What is difference on how to handle Pharmacist THanos vs. Drax himself?
3.1.11 - Order Level Exception
Transfer from retail Walgreens pharmacy
We follow SOP to fill the valid Rx from the central profile through HD.
2.6.1 - For a pharmacist calling, we check the profile to see if the Rx valid, then connect Immediately to our H.D. pharmacist
300
" I AM GROOOOOOT.........I AM .......GROOOT.....I......AM GROOOT.......I AM GRRROOT I AMMM GROOOOT III AM GROOT I AM GROOT I AM GROOOT!"
- This section helps up handle and understand this caller's language-
2.5.20-
VOYCE – Language Line
Is used to contact an interpreter to speak on behalf of the patient to us
300
Comments:
chd
GVT
Issue#152346
12/11/2109 P.A. Maw has PA from Dr. Strange for LITERS of Depo-Test....."
PA vs. P.A.
-what do these above /\ similar Abbreviations mean?-
PA = Prior Authorization - Rx requires a PA
P.A. = Physician’s Assistant - The P.A. called in to clarify the Rx
400
" Could you combine my refills and send me a 3 month or even just the whole year supply of Actiq Lolis please, instead of just this months? "
-This section refers to what and how an agent is able to combine fills-
-What kind of steps should be taken for Drax's RX-
3.2.7 -
we could possibly after checking/contacting insurance, change the fill for a 90 days supply,
however we cannot help Drax
this Rx not written for a 90 days supply and is CII we cannot help! pbr must send new rx
400
"Hello this is Technician ZenWhoberi-Ben-Titan, and our system is down being a pain again...I swear one day...sorry, anyway i need you to have Mr. Destroyer's RxOnFile released to be filled A.S.A.P"
-This is Part of Job Aid, this section in S.o.P refers to the creation of this ISSUE and how to handle it -
What other issues are to be created?
3.7.28 - Psyche!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!1
We do not create issues for just releasing a RxOnFile normally, so do not create an Rx On File Issue , we instead just select the RxOnFile button and follow SOP to complete the work as normal
400
"Hey there, ummm... so Mantis says she only has enough SonBlocker for this week, and needs more soon...Could you guys send it faster before mini me's are show up?"
-This section informs us what options Drax has available -
-What can an agent due at least once as good customer service?
3.1.5-
Patient does not have enough medication on hand until the next order date. There are many options for them , but if they wish to pay for expedited shipping we may process it that way.
we can offer a one time courtesy Expedition to a customer
FOR THE SAKE OF THE UNIVERSE!!!!
400
1!!!!!!!!!!!!DAILY DOUBLE!!!!!!!!1
WHAT ARE YOU WILLING TO LOSE???
WILL YOU BE BLESSED BY YOUR GOD DAD OR
SNAPPED BY THANOS??!?!?!?!?!?!?
"Hello again...So i don't have any more lollipops of the Acatiq or something.....My heart is too strong.... i can feel it cracking my ribs... trying to break free again.....when can i get more?"
- This section refers how to check the status of a shipment and another section refers to how a patient can get a small amount filled early to hold them over until an order arrives-
When can Drax be saved?
400
"Oh ughhhh...Mr...Lord...no...I will say Quill instead, we managed to have your access cover the order....this time..."
- What does this ADJ Abbreviation Mean? -
ADJ = Adjudication Prescription - claim has been successfully paid by the customer’s insurance
500
"Okay Mr. Destroyer..., I have found that the Copay for your 360 liters of 1 liter injections four times daily of Depo-Testosterone in the system to be $1.01"
-Using this convenient system tool-
and what do they have to be part of?
3.7.9-
What is Pace Tool Copay
and has to be an AllianceRx PRIME Member
500
" Hey friend, I never got my cases of Adderall and take 20 to 24 30MG tablets a day and you said it was to be here about 2 weeks ago "
-This ENTIRE section details how to work an order than you are certain will not reach the customer -
-What Unique Route is Used-
3.5-
"Customer Did Not Receive" Issue -
This issue Open Issue can be created if the order has been missing for more than 10 days but less than 30
and this is unique in that it is routed to MSFIR
500
"hmm...hey Gamora...there's nothing here, but he calls all the time....where did all his meds go?"
- This section of refill for mail service requests refers to why the Local Profile may be empty-
It also has options for refills and transfer procedures-
Where may valid Rx's be?
3.1.2-
Other mail service refill request types has what information can be found in the local profile as well as many other procedures an agent my go through for rx's to be filled for transfered
The Local Profile only has valid Rx's that are on file in our store, and can be filled for H.D.
We may use the central profile to find valid Rx's in other stores and proceed from there
500
" Hello again my friend, um the ship is in flight right now, I'm sorry i know Peter just called our stuff in ,but I don't know if your drones can get here...I've seen the Black Odor closing in... ha!....is there any way to just have them take the stuff to my old house for now?"
- This type of issue is created to update an order destination and what to do if it's already on the way-
How can we help Drax? if this is a temporary location
3.7.8 - Shipper/Address Issue to create
You create this issue and attempt to update address for order, however if in STP contact HELP desk Immediately to resolve
2.8.9- Add/updating info
We can use the Alt Address to have a temporary address placed on fild
500
"Okay Mr. Destroyer I see that the system is just having a slight delay please hold for me...."
" okay so it says FROF from what i see... do you remember what to do even? or should i get.......Pharmacist to help us...."
FROF - What does this means???
How long must they wait?
Failed Rx on File -
Script level exception created by the system when Promise cannot reprocess a claim when the Rx is taken off file due to incorrect processing information (i.e. an incorrect UPI or expired Rx date.
Turn-Around Time: 0-5 days