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Mail Order Pharmacy

Nick

Created on June 11, 2024

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Transcript

07.

Mail order pharmacies deliver prescriptions to the home of the member. Convenient, easy and often less costly.

SECTION ONE

Mail Order Pharmacy

They also often allow, as is the case with TFE, for members to fill a 90-day supply of the medication, as opposed to the allowed 30-day supply at retail. In addition, mail order pharmacies such as Optum Rx may sometimes be able to secure medication for a patient which is in short supply or difficult to fill at the retail pharmacy.

LEARN MORE

Optum Rx Home Delivery serves millions of Americans.

OptumRx is the primary mail order pharmacy for multiple BMR plans, including TFE. OptumRx Home Delivery has a dedicated website, app, and member service phone line, where members can get updates on the status of their rx orders and delivery.

TEAMSTERS & FOOD EMPLOYERS

Mail Order Pharmacy

Teamster and Food Employers

About Mail Order Pharmacies

  • Mail order pharmacies provide the convenient benefit of having a member’s prescription delivered right to their door.
  • They also often allow, as is the case with TFE, for members to fill a 90-day supply of the medication, as opposed to the allowed 30-day supply at retail.
  • In addition, mail order pharmacies such as Optum Rx may sometimes be able to secure medication for a patient which is in short supply or difficult to fill at the retail pharmacy.

About OptumRx

  • Optum Rx is a national mail order pharmacy, currently serving millions of Americans.
  • They are the primary mail order pharmacy for multiple BMR plans, including TFE.
  • They have a dedicated website, app, and member service phone line, where members can get updates on the status of their rx orders and delivery.

Vaccine Copays

Teamsters and Food Employers
$0 Copay
Not Covered
RSV Vaccines
Teamsters and Food Employers

COPAY STRuture

Generic Brand Non-Preferred BrandRetail $10 $15 $30Mail Order $20 $30 $45Specialty 30% co-insurance

TFE Groups

Teamsters and Food Employers

General Breakdown

  • TFE members are broken up by into groups by member status (Active, Cobra, Medicare Retiree and Non-Medicare Retiree) as well as plan type (PPO, Kaiser, Aetna).
  • General coverage (copay structure, drug exclusions, etc.) are mostly the same between groups, but it is important to confirm which group a member is a part of.
  • Certain things like diabetic supplies or specialty medications, may vary from group to group. Check the RGB and confirm with team leaders if you are unsure.

Topics to Be Covered

Teamsters and Food Employers

The objective is to provide a fundamental overview of one of BMR's most important customers. You will receive information regarding all aspects of the TFE plans, to prepare you to assist their members effectively and efficiently.

Groups and Copay Structure

Who/what is TFE?

Pharmacy Information

Important Contacts

Drug Coverage

Additional Client-Specific Characteristics
  • TFE Second Level Appeals
  • Covid-19 Policies
  • Breaking Insulin Boxes

Unit 1

Training Module

Yep, you read that right. Interactivity and animation can turn even the most boring content into something super fun. In Genially, we use AI (Awesome interactivity) in all our designs so that you can level up with interactivity and turn your content into something that engages and provides value.

When giving a presentation, you need to go after two main objectives: to convey information and avoid yawns. To do this, it can be good practice to make an outline and use words that will be imprinted in the memories of your audience.

Unit 1

Training Module

An awesome title

Contextualize your topic

Yep, you read that right. Interactivity and animation can turn even the most boring content into something super fun. In Genially, we use AI (Awesome interactivity) in all our designs so that you can level up with interactivity and turn your content into something that engages and provides value.

Unit 1

Training Module

An awesome title

An awesome title

An awesome title

Contextualize your topic

Contextualize your topic

Contextualize your topic

With the Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like!

Yep, you read that right. Interactivity and animation can turn even the most boring content into something super fun. In Genially, we use AI (Awesome interactivity) in all our designs so that you can level up with interactivity and turn your content into something that engages and provides value.

Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

Unit 1

Training Module

An awesome title

An awesome title

An awesome title

Disciplines such as Visual Thinking facilitate the taking of visually rich notes through the use of images, graphs, infographics, and simple drawings. Give it a go!

Visual content is a transversal, universal language, like music. We can understand images from millions of years ago, even from other cultures.

Did you know that Genially allows you to share your creation directly, with no need to download? All ready for your audience to view it from any device and share it anywhere.

Unit 1

Training Module

Here you can put an important title

Contextualize your topic with a subtitle

Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

Unit 1

Training Module

‘Use this space to write a quote. And remember, always name the source.’

Here you can put an important title

Contextualize your topic with a subtitle

Genially

With the Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like!

Unit 1

Training Module

An awesome title

Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

An awesome title

Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

Training Module

Unit 2

Image Compositions

Sections like this help you create order

Unit 2

Training Module

Visual content is a transversal, universal language, like music. We can understand images from millions of years ago, even from other cultures.

Our brain is biologically primed to process visual content. Almost 50% of our brain is involved in the processing of visual stimulus.

When you tell us a story, it excites us, and can even move us, which means that we remember stories up to 20 times more than any other content we consume.

Unit 2

Training Module

Visual content is a transversal, universal language, like music. We can understand images from millions of years ago, even from other cultures.

Our brain is biologically primed to process visual content. Almost 50% of our brain is involved in the processing of visual stimulus.

Unit 2

Training Module

An awesome title

An awesome title

An awesome title

Contextualize your topic

Contextualize your topic

Contextualize your topic

And use this space to caption it. This is essential for giving your presentation more visual impact.

And use this space to caption it. To insert an image, you can upload it from your computer or use the resources in the Editor.

And use this space to caption it. You can upload an image from your computer or use the resources available in Genially, on the left side of the Editor. Knock their socks off!

Unit 2

Training Module

We generally grasp visual content better. Visual content is associated with cognitive and psychological mechanisms. We receive things through our eyes; the first image is what counts. We associate visual content with emotions.

Unit 2

Training Module

An awesome title

Contextualize your topic

Yep, you read that right. Interactivity and animation can turn even the most boring content into something super fun. In Genially, we use AI (Awesome interactivity) in all our designs so that you can level up with interactivity and turn your content into something that engages and provides value.

Unit 2

Training Module

With interactive images. Include additional information and display it with one click.

Surprise your audience with interactive images

Animate your content and take it up a notch.

Surprise your audience with additional info.

Unit 2

Training Module

Insert an awesome video for your presentation.

And use this space to caption it. Multimedia content is essential in a presentation, to really wow your audience. What’s more, this way you can summarize the content and entertain your audience.

Unit 2

Training Module

Insert an awesome video for your presentation.

And use this space to caption it. Multimedia content is essential in a presentation, to really wow your audience. What’s more, this way you can summarize the content and entertain your audience.

Insert an awesome video for your presentation.

And use this space to caption it. Multimedia content is essential in a presentation, to really wow your audience. What’s more, this way you can summarize the content and entertain your audience.

Unit 2

Training Module

Unit 2

Training Module

An awesome title

An awesome title

An awesome title

Disciplines such as Visual Thinking facilitate the taking of visually rich notes through the use of images, graphs, infographics, and simple drawings. Give it a go!

Visual content is a transversal, universal language, like music. We can understand images from millions of years ago, even from other cultures.

Did you know that Genially allows you to share your creation directly, with no need to download? All ready for your audience to view it from any device and share it anywhere.

Training Module

UNIT 3

Timelines y Diagramas

Sections like this help you create order

UNIT 3

Training Module

20XX

20XX

20XX

Contar historias con orden y jerarquía es fundamental.

Telling stories with an order and a hierarchy is fundamental.

And add toppings: interactivity and animation.

Phase 1

Phase 3

Phase 1

20XX

20XX

20XX

Phase 2

Phase 4

Phase 2

Turn numbers into a story with a graph.

Icons are always a good ally.

Icons are always a good ally.

UNIT 3

Training Module

Icons are always a good ally.

Phase 1

20XX

Telling stories with an order and a hierarchy is fundamental.

Phase 2

20XX

Turn numbers into a story with a graph.

Phase 3

20XX

And add toppings: interactivity and animation.

Phase 4

20XX

UNIT 3

Training Module

Interactivity and animation can be your best allies for making content fun.

Here you can put an important title

Contextualize your topic with a subtitle

That’s why in Genially, we use AI (Awesome interactivity) in all our designs, so that you can level up with interactivity and turn your content into something that engages and provides value.

With the Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like!

Do you need more reasons to create dynamic content to tell stories?

UNIT 3

Training Module

Wow effect

Magic

Design

Interactivity

Animation

Creativity

You can add interactivity to your timeline.

The important thing is for everything to be suitable for the topic.

MIND MAP

Interactivity

Animation

Creativity

Wow effect

Magic

Design

And for you to wow your audience.

And animations to make it fun.

Contextualize your topic

Training Module

quiz

Sections like this help you create order

QUIZ 1/5

Training Module

QUIZ 2/5

Training Module

QUIZ 3/5

Training Module

QUIZ 4/5

Training Module

QUIZ 5/5

Training Module

Bibliography

Training Module

Use this space to write down your sources of information. Citing where you got the info from is always a plus.

The APA Standards (Publication Manual of the American Psychological Association) are indispensable when citing bibliographies.

This is a set of guidelines for citing any type of project: theses, reports, presentations ... You name it!

These references include information on the author, date of publication, title, and source.

Here’s a quick little guide: Arial or Times News Roman font, 12 pt, 2.0 line spacing, left aligned, and unjustified.

Congratulations!

Guidance

If a member inquires about filling a 90-day supply, MSRs can refer them to Optum Rx to get mail order set up.

Got an idea?

Let the communication flow!

With Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like! Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

  • Generate experiences with your content.
  • It’s got the Wow effect. Very Wow.
  • Make sure your audience remembers the message.

Helpful Context

Unlike with TFE, some plans do not have vaccine coverage through their pharmacy benefits. In these cases, their vaccine coverage is likely through medical, meaning they must have them administered at an MDO.

Got an idea?

Let the communication flow!

With Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like! Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

  • Generate experiences with your content.
  • It’s got the Wow effect. Very Wow.
  • Make sure your audience remembers the message.

WATCH OUT

When implementing a PA, it is important to run a trial claim to ensure the medication is being paid out in accordance with the plan’s copay structure.

Got an idea?

Let the communication flow!

With Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like! Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

  • Generate experiences with your content.
  • It’s got the Wow effect. Very Wow.
  • Make sure your audience remembers the message.

WATCH OUT

  • For both Aetna and Kaiser members, they must fill their Specialty meds through their respective provider.
  • The same is true for diabetic supplies, except for Aetna Medicare Retirees, who are covered by BMR.

More Information

Different plans/clients are contracted with different mail order pharmacies. TFE’s is Optum Rx.

Helpful Context

Different plans/clients are contracted with different mail order pharmacies. TFE’s is Optum Rx.

WATCH OUT

If you run into an unfamiliar vaccine that is rejecting at the pharmacy, consult with the clinicians before placing an override.

Got an idea?

Let the communication flow!

With Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like! Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

  • Generate experiences with your content.
  • It’s got the Wow effect. Very Wow.
  • Make sure your audience remembers the message.

Helpful Context

TFE members can fill 90 days through mail order but only 30 days at retail, so despite the higher copay of mail order, the cost per dose is lower.

Got an idea?

Let the communication flow!

With Genially templates, you can include visual resources to wow your audience. You can also highlight a particular sentence or piece of information so that it sticks in your audience’s minds, or even embed external content to surprise them: Whatever you like! Do you need more reasons to create dynamic content? No problem! 90% of the information we assimilate is received through sight and, what’s more, we retain 42% more information when the content moves.

  • Generate experiences with your content.
  • It’s got the Wow effect. Very Wow.
  • Make sure your audience remembers the message.

Guidance

If a member inquires about filling a 90-day supply, MSRs can refer them to Optum Rx to get mail order set up.