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Higher Education Presentation
Adriana Núñez
Created on October 21, 2024
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Transcript
Welcome to RO Med OPs
Workflow
Actions taken by RCT Agents
Alerts (Phyz)
Handles insurance procedures and submissions for Ro patients in the Body Program. Phyz can take over the BV process if the team is unable to do it.
Voicemail Tickets
We dont take calls from patients, however, they still can reach out and leave us a voicemail for us to reply to. The RCT team handles these and routes them to the appropiate team to resolve the inquiry.
Manual ID Verification
Our RCT team handles the IT verification for the patient, either validating or if necessary reaching out to the patient if there are ay issues with either one.
Other non-clinical task
Whenever an action needs to be taken these task are created for the RCT team to execute. They can be automated or created by someone else.
Med OPs Workflow
Alerts(Phyz)
Benefits Verification
phyz can take over the bv for the patient if our team wasnt able to
Prior Authorization
handles all PA submitions for the patient
Rx Triage
handles sending rx to the pharmacy for the patient
Refund/ credit question: Regarding discounts or refunds, or credits for the program.
RoBodyprogram cancelation request: A task will be created and we have to cancel the subscription.
Updated Insurance Info: patient updated their insurance
Lab cancelation: Can also be when patient wants a new one, so the previous one should be cancelled.
Pricing and shipping: questions about price of medication
order management: checking status of orders, assist patient with their orders
Did you know that allows
message non-clinical: created in response to something the patient said(check the task to make sure the patient doesn't need anything)
Med OPs Workflow
Tipes of non-clinical
- Addressing payment/billing services
- Handling pricing, credits, or promo questions
- Tracking order statuses
- Providing medical records/documentation
- Changing order frequency or refill dates
- Collecting info to transfer RX to local pharmacy
- Handling issues with completing an OV or submitting a renewal
- Scheduling appointments
- Reassigning patients
- Reporting quality issues(related to orders)
- Detailing ingredients of products(RX or OTC items)
- Handling any other questions comments or concerns that are of clinical nature
- Clinical counseling or support in adjusting treatment plans/RX changes
- Changing the status of active/approved TRs
- Confirming a patient's gender identity/assigned sex at birth
- Providing additional medical/clinical info per a provider's request
- Addressing patient questions or comments abt side effects
- Most importantly if you are unsure if u should respond, please reach out to your tl
Messages RCT can respond
Messages RCT cant respond
Best practices
Things to consider
- Speak naturally, so the patient can feel like they are speaking with a human.
- If there are multiple issues, respond to each question or concern in a new paragraph.
- If a patient is overly frustrated or our previous responses did not help de-escalate, please flag to your lead for a review and they will assist in crafting a response.
- Greet the patient always, unless, they have been greeted many times in that case, just asnwer the question.
Things to avoid
- Sending the same response to the patient. It is important to read the full convo to avoid doing this.
- -Sending long emails, we should be concise.
- -Apologizing too much.
- Addresing all issues in the same parragrapg
all order created for the patient regardless of status
care.ro.co is where you can manually look for a patients account
see patient personal info and the condition plan they have, and their history
edit/update the patient info and acces login as patient
can see the plans written/created for each approved treatment request.
Add credit to the patient's account
Order history tab
Searching for patients
Overview tab
subscription tab
You can see if the patient subscription is active, can also cancel the subscription