PreRX
The process when you have an MD who is not in IRIS
What is process under "UNKNOWN ERX PRESCRIBER" with NPI 1497704431? (Please do not update any information under that NPI)
When a sig is written with a dash (ex. 2-4), replace the dash with the word ____
What is "to"?
Procedure for "Early Fill HOLD" with the "Next Fill Date" as a future date
What is profile for TSTF until date listed in hold?
The process when a DE hold for "Review customer coverage for manufacturer copay card" is applied under a plan with Medicare.
What is review coverage tab, make sure copay card is NOT on line, and release hold?
(Copay Card with a Government plan is illegal and should never be done)
When you call the prescriber for a PCC order, and the office is closed (Hint: IRIS has a button for it)
What is a call try?
The correct hold for items such as "blood pressure machine" or "wheelchair"
What is DE hold for "Not available from Mail"?
PA forms are to be sent here and not attached to profile
What is Exceptions?
If the plan is not listed in the responsibility file and blank in portal
What is call Bumblebee line to confirm responsibility and send info to DEX support chat?
The only state that uses State Regulation Quantity Increase Consent Task
What is Michigan?
The hold applied when verifying a diabetic supply with a patient
What is a Diabetic Question Hold?
OptumRX brand preference for a pen needles/syringes
What is BD/Embecta?
The hold we apply when we need to verify directions on a TRANSFER RX that states "Please see attached directions"
What is an Inbound Transfer Hold?
When a PA is submitted and the medication is on HFF, the drop date should be set as this.
What is 1 month out?
If Rx received for unspecified diabetic supplies with no shipped history and no manual survey on file
What is run price check for plan preference and process per procedure/plan preference (If error when doing price check, then okay to process for Optum RX One touch) ?
Rx written for a specific brand of meter, test strips, lancets or lancet device but has no history or manual form on file
What is process as written?
This website can be used to find drugs in IRIS
(IE:OTC, brand vs, generic names)
What is Clinical Pharmacology?
Complete SIGs include a _____ (Hint: 4 things)
What is a verb, medication form, route of administration, and frequency
Type of medications that get PA instead of applying a DUR-PPS for a Rej 88
What are Anticholinergics?
For Collab MD hold, the process for if the prescription is a 3310 renewal form with NO change to the prescriber
What is check the Collab Phys box on the Rx form and release the hold?
The procedure when previous agent forgot to document attempt/2nd call try
What is document the attempt using the document call function under Actions in SOF?
Downward Titration beyond 90ds get this hold.
What is DE hold with "Downward titration greater than 90 days. Process and apply an RPH review hold"?
The day supply for OZEMPIC PEN 0.25/0.5MG DOSE, sig stating to inject 0.25MG for 4 weeks, then 0.5MG weekly thereafter, with a quantity of 2 boxes with 0 refills.
What is 70 day supply (42ds for 1st box and 28ds for 2nd box)?
Procedure for Rej 76 for min day supply for a PAW medication WITHOUT refills
Profile and send "Min Qty Limit Verse" 358
The process for when a transfer from MD state was first filled 6 months after the original date.
What is make 1x attempt to patient, send a PSC (if needed), cancel line, d/c RX, and cancel order?
The procedure followed when a response was received on an order but it is unclear or has missing information & does not answer our clarification request.
What is send a 1x fax to MD then follow No MD Callback procedure?