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CD #1
Training Operations
Created on March 5, 2025
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Transcript
A member calls saying their pharmacy told them their prescription is not covered. How can you guide them on next steps?
Submit a coverage determination and advise of the timeframe for review.
Advising to try another pharmacy.
Confirm that the medication is not on the formulary.
Both B&C
Correct! These details help determine next steps: Confirming that the medication is not on the formulary. Submitting a coverage determination and advise of the timeframe for review.
Incorrect. These details help determine next steps: Confirming that the medication is not on the formulary. Submitting a coverage determination and advise of the timeframe for review.
Incorrect. These details help determine next steps: Confirming that the medication is not on the formulary. Submitting a coverage determination and advise of the timeframe for review.
Incorrect. These details help determine next steps: Confirming that the medication is not on the formulary. Submitting a coverage determination and advise of the timeframe for review.
Incorrect. These details help determine next steps: Confirming that the medication is not on the formulary. Submitting a coverage determination and advise of the timeframe for review.
Incorrect. These details help determine next steps: Confirming that the medication is not on the formulary. Submitting a coverage determination and advise of the timeframe for review.
Incorrect. These details help determine next steps: Confirming that the medication is not on the formulary. Submitting a coverage determination and advise of the timeframe for review.
Correct! These details help determine next steps: Confirming that the medication is not on the formulary. Submitting a coverage determination and advise of the timeframe for review.