WorksheetsResource Utilization
Total questions: 25
Worksheet time: 14mins
A Pharmacist is calling to xfer a rx, who do we transfer them to?
IBRT
Account Solutions
RPH
Take the information ourselves
What is the proper greeting for CTI authenticated callers?
Thank you for calling CVS Specialty
Thank you for calling, how may I help you?
Thank you for calling CVS Specialty, am I speaking with the patient?
Thank you for calling CVS Specialty. My name is <your name>. Am I speaking with <caller name>? I see you are calling about <caller intent>. Let me pull up that information for you.
What is the proper greeting for Silverlink calls?
Thank you for calling CVS Specialty, My name is...Am I speaking with...
This is <your name> from CVS Specialty calling about a prescription.” Ask to speak to the patient or their authorized representative. “For the security and privacy of your prescription information, please verify the following…” I need to let you know that this call is being recorded or monitored for quality purposes.
This is...calling from CVS Specialty, may I have your name?
Thank you for calling CVS Specialty. My name is <your name>. In order to protect your privacy, I need to ask you a few questions before we proceed.
How many seconds are there until you have reached “dead air” on a call?
10
7
5
15
When an order needs to be scheduled, we create a contact pt task, True or False?
True
False
How long is the proper hold?
100 seconds
2 minutes
5 minutes
1 min/ 30 sec
A pt calls in to schedule, but an ECS rejection populates: Check DNF code. Pt has a DNF 96, what is this DNF? What do we do next?
DNF 96 - Bankruptcy.
Transfer to Account Solutions
DNF 96- Collections
Transfer to IBRT
DNF 96- Collections
Transfer to Account Solutions
DNF 96- Pt death
Transfer to RPH
The mdo is calling for a CMK pt to initiate a PA, we transfer to SGM PA, True or False?
False
True
Who do we contact when a pt has a question about dosage instructions?
RPH
IBRT
We provide the information
Advise to contact their insurance
What do we do after scheduling an MAJ pt?
Complete scheduling and close the call
Provide the MAJ disclaimer
Transfer to IBRT
Create a callback
What should we do at the beginning of each call? (Select all that apply)
Check the notes
Check current and recent orders
5 second sweep
Start the call tracker
We can skip “digital” in the order guide, True or False?
True
False
How many seconds do we have to answer a call?
5
10
7
3
We need to repeat the delivery address back to the pt when scheduling, True or False?
True
False
How do we check the reason for a denied PA? (Select all that apply)
Contact IBRT
Check the notes
Insurance Tab
PeopleSafe
A pt has an open order and stated “I am calling about my balance” what do we do?
Contact Assist Line
Check the current recent orders and assist the patient
Transfer to Account Solutions
Advise to contact insurance
How do we authenticate third parties?
Ask for name, last initial, and title
We do not have to authenticate
"Is the pt aware that you are calling on their behalf?"
What are the first four steps in adding Insurance in SPRx?
-Confirm Insurance information with Patient
-Access Check Eligibility via the left-hand navigation
-expand the Eligibility line to view all Insurance Information.
-Confirm Check Eligibility results match the information the Patient provided, and add BIL code as shown below through the patient’s Insurance tab
Add the bin
Add the pcn
Add the Grp
Add the Member ID
Check eligibility
Create a BIL note for BV
Run a claim
Schedule Rx
Just add the processing information and run a claim
Prudent=UC means...and what do we advise the pt before the order ships?
Unable to Contact
Advise to contact PrudentRx
Unable to Cover
Transfer to Account Solutions
Uncoverable Content
Transfer to Enrollment
Unable to Contact
Transfer to Account Solutions
A patient's account shows PrudentRx status "002" What do we advise?
Advise them to contact their insurance
Advise that we cannot fill their rx.
Advise the pt that they are enrolled in a HDHP and need to satisfy their deductible before PrudentRx will cover their rx
Nothing, we advise that they are enrolled with PrudentRx
A pt's PrudentRx status shows "PrudentRx=E" and the medication is eligible with a "0" copay, but the claim shows a $600 copay, which copay do we quote to them?
Advise them we will contact them for their copay
Advise of $600 copay
Call Assist Line
Advise of $0 copay
We do not have to offer the survey on each call
True, we do not have to offer them on calls where the pt is upset and the issue is not resolved
False
True
False, we even offer them when the pt is upset
Where can resources be found to assist with everyday call handling?
(a)
What is the work instruction that assists with call grading criteria?
(a)
What is the work instruction to use to avoid inappropriate transfers?
(a)
