CPR+ Queues

Question 1

1. Incoming Faxes

Answer 1

Faxes for the entire pharmacy come into this queue. The Customer Service Team works together to route faxes to the appropriate teams by verifying the patient, who the fax is from, and what it is regarding.

Question 2

2. Patients w/Incomplete Info

Answer 2

Patient’s prescriptions will drop into this queue if the “information complete” box is not checked on the patient’s demographics page after being registered. There should never be any patients in this queue.
The Customer Service Team works in this queue.

Question 3

3. Order Entry /Completion

Answer 3

Multiple Teams work out of this queue. Orders in this queue do not have a claim attached.
BV, RPH, PA, PAP work out of this queue.

Question 4

4. Rx Setup

Answer 4

This is where the script directions, day supply, and quantity are typed and get a script #. They verify patient name, MD, and refills. Comment box must be precise. Direction templates are available. Only able to adjudicate 1 claim at a time.

Question 5

5. Claims to Adjudicate - New Rx’s

Answer 5

In this queue the claim is adjudicated through primary and secondary coverage and the profit margin is verified. If not in guidelines, will be investigated by management.

Question 6

6. Benefits Verification - New Rx

Answer 6

This queue is not used

Question 7

7. Rx Verification

Answer 7

In this queue pharmacists will verify each new prescription before it moves on to the next step. This is only done on the first fill of each prescription.

Question 8

8. Claim Exceptions

Answer 8

This queue is not a regular part of the prescription workflow. Billing on scripts with live claims can be moved to 8 to be reprocessed.
Finance Team works in this queue.

Question 9

9. Authorization Tracking

Answer 9

We do not use this queue.

Question 10

A. Patients to Contact

Answer 10

Scripts ready to be scheduled for delivery are found in this queue Scripts in this queue have active claims attached except for Medicare B scripts.
The adherence team works in this queue.

Question 11

B. Patients to Contact - Refills

Answer 11

Scripts that may be due for refill in the in the next 7-10 days are in this queue. These scripts are “stored refills” that do not

Question 12

C. Claims to Adjudicate - Refills

Answer 12

This queue contains scripts that need to be ran through the insurance for a true claim after a refill has been scheduled in queue B.

Question 13

D. Benefits Verification - Refills

Answer 13

We do not use this queue.

Question 14

E. Print Labels / Documentation

Answer 14

In this queue the necessary paperwork is printed/selected based on the medication, address and delivery route are verified and submitted to FedEx. Paperwork and package label is placed in bin and sent down conveyor belt - Dispensing and Distribution Team

Question 15

F. Select Lots / Fill Rx

Answer 15

In this queue the necessary lot numbers and expiration dates are selected - Medication is counted, labeled, put in bin and sent down the conveyor belt - Dispensing and Distribution Team

Question 16

G. Order Verification

Answer 16

In this queue the pharmacists will verify that everything was filled and processed properly. - Dispensing and Distribution Team

Question 17

H. Delivery Ticket Confirmation

Answer 17

This queue shows all packages that are ready to ship the current day. - Dispensing and Distribution Team

Question 18

I. Rx Expiration / Zero Refills

Answer 18

In this queue pharmacists and designated technicians verify requesting refills is appropriate and nurse triages are then sent to our clinics. - Nurses and CSR

Question 19

J. Rx’s to Discontinue

Answer 19

This queue lists the scripts to be discontinued after nurse triages have been requested or patient has been taken off the medication– Completed by a pharmacist.

Question 20

K. Clinical Follow Up

Answer 20

This queue is not used.

Question 21

L. Billing Follow Up

Answer 21

This queue is used by our Financial Team for follow ups (Utilized in the IV list)

Question 22

M. TherigySTM Activity Manager

Answer 22

This queue is not utilized.

Question 23

P. ePrescription Manager

Answer 23

In this queue prescriptions from AON clinics come in for us to process. The patient and prescriber are attached to the script and is then sent to either BV-RPH or REMS-LPN. The customer service team works in this queue.