PrescribeMedicare User Guide...PrescribeMedicare User Guide 9.0 11 In the Patient Medicare Profile...

PrescribeMedicare User Guide Version 9.0 10.14.2020

2 PrescribeMedicare User Guide 9.0

Table of Contents 03 Identify Patients

03 Your Patient List 04 Filter 06 Sort

07 See Opportunities in PharmacyNow 09 Educate Patients

09 Campaigns

10 Consult with Patients 10 Open the Patient Medicare Profile

11 In the Patient Medicare Profile 13 Conduct a Comparison in eHealth

13 Plan Filters & Sorting 13 Plan Types 13 Plan Filters 14 Sort Options 15 Add or Edit Doctors & Prescription Drugs 15 Add or Edit Doctors 16 Add or Edit Prescription Drugs 18 Plan Details 19 Plan Overview 19 Plan Details 20 Benefit Highlights 20 Drug Coverage 21 Doctor & Hospital Coverage 22 Potential Drug Costs 23 Plan Brochures 24 Compare Plans 25 Print or Email Plans 25 Mark Plan Review as Completed


Identify Patients Your Patient List

To access a list of your Medicare eligible patients, click on PrescribeMedicare in the control panel of your Patient Engagement Center. Within this screen, your patients will fall into one of three categories:

1. Plan Review Eligible: This tab consists of Medicare eligible patients that have yet to complete or decline a Medicare plan review.

2. Completed: This tab consists of patients that have been marked as completed a

Medicare plan review. 3. Declined: This tab consists of patients that have been marked as declined a Medicare

plan review.


FILTER Use filters to further prioritize your patients. First, click the Filters button. Then select any filter option from any of the available tabs to customize your view. Within the Medicare tab, you can filter by any of the following categories:

1. Average Copay: The values displayed in the Average Copay column are

the sum of the copays paid on all the medications that the patient has filled year-to-date, divided by the total number of medications. The patients that are spending the most out-of-pocket for their medications would, therefore, most benefit from a Medicare plan review. Click on Any Average Copay to select any given range of values.

2. Low Income Subsidy: If you only want to see low-income subsidy patients, click on Any Income and select Is LIS from the drop-down menu.


3. Enrollment Period: Click on Any Enrollment Period to choose which eligibility period to view. Open Enrollment lists all Medicare patients that will be eligible to change or renew their plan for the next year. Outside Open Enrollment lists patients turning 65 (and therefore eligible for initial enrollment).

4. Result: For patients who have already completed a plan review, you can filter by Any Result within the Completed tab. Select one of the following options from the drop-down menu: Plan comparison emailed, Plan comparison printed, Enrolled in plan, Other.

Use the remaining tabs to narrow your list down to patients that belong to a particular Demographic, take a chosen Medication, or have a specific Plan type. To remove a group of patients from your list, use the Exclude tab.

Click Apply to view your updated list.


SORT By default, the patient list is sorted by Total Billed. You can sort the patient list by a variety of options.

1. Click on Add Sorting to select an option.

2. The patient list will update to display in descending order. Click on the arrow to display the patient list in ascending order.

3. To remove the sort, click the X button.


See Opportunities in PharmacyNow

PharmacyNow displays Medicare plan review opportunities for patients expected to visit the pharmacy in the upcoming week.

During Open Enrollment, the patient criteria are: • Age 65 or older • 3+ maintenance medications • Scheduled to visit pharmacy yesterday, today, or the next 7 days

Outside of Open Enrollment, the patient criteria are: • Turning 65 within 4 months OR turned 65 in past 4 months • 3+ maintenance medications • Scheduled to visit pharmacy yesterday, today, or the next 7 days

You can schedule Medicare plan reviews with these pre-identified patients. If you speak with a patient and set an appointment, mark it in PharmacyNow.

1. Click on Now in the Control Panel to open the PharmacyNow screen.

2. Under any displayed date, click on PrescribeMedicare Opps to expand the listing.

3. To schedule an appointment, click on Schedule to the right of the patient’s information.


4. In the pop-up window, enter the appointment date and time and then click on Save.

5. The opportunity will disappear from PharmacyNow. Click on the calendar icon in the Control Panel to view the scheduled appointment on your calendar


Educate Patients

Campaigns

If you have PharmacyGrowth, you can record three messages to educate patients. Any Medicare Eligibility messages can be sent to patients as an OnDemand campaign.

Visit PrescribeWellness University for instructions on recording campaign messages. Click on the graduation cap in the control panel to access University.


Consult with Patients Open the Patient Medicare Profile

Once you’ve identified your patient, you will then need to navigate to their patient profile. To open the profile from the PrescribeMedicare screen, click on the patient’s name.

You can also click on the Medicare tab within the patient profile.


In the Patient Medicare Profile To begin a Medicare plan comparison with the patient, click Yes, Compare Plans. The patients active medications and physicians will then load into our plan finder tool.

Please review the next section Conduct a Comparison in eHealth (page 11) to learn how to complete a Medicare plan review with our plan finder tool. After completing a plan comparison with the patient:

1. Click Mark as Completed. 2. In the pop-up window, select the Result of the plan review from the drop-down menu. 3. Enter any relevant information in the Notes section (max 250 characters). 4. Click Done. 5. The screen will now show Completed on [today’s date]. Click this button to review the

information as needed.


If the patient has declined a Medicare plan review: 1. Click No, Decline. 2. In the pop-up window, select the Reason from the drop-down menu. 3. Enter any relevant information in the Notes section (max 250 characters). 4. Click Done. 5. The screen will now show Declined on [today’s date]. Click this button to review the

information as needed.


Conduct a Comparison in eHealth Plan Filters & Sorting PLAN TYPES Medicare Advantage plans are show by default, but you can filter by any of the following options:

• Medicare Advantage Plans

• Medicare Supplement Insurance Plans

• Medicare Part D Plans.

PLAN FILTERS Medicare Advantage Plans can be filtered by Doctors, Drugs, Company, Monthly Premium, Plan Features, Pharmacy and Plan Type. Medicare Supplement Insurance Plans can be filtered by Company, Monthly Premium, Plan Type, Plan Features, Part A Deductible, and Part B Deductible. Medicare Part D Plans can be filtered by Drugs, Company, Monthly Premium, Deductible, Your Selected Pharmacy, and Low Income Subsidy. Doctors or Drugs must be entered for the filters to appear. When filtering plans by Doctors or Drugs, only plans covering the Doctors or Drugs will be displayed.


SORT OPTIONS If no Doctors or Drugs have been entered, Plans can be sorted by Monthly Premium and Company. The sort will default to Monthly Premium. When Doctors and Prescription Drugs have been added, Medicare Advantage Plans can be sorted by Monthly Premium, Company, Drug Costs, Drug Costs + Premium, and Doctor Coverage. The sort will default to Doctor Coverage.

When the Pharmacy has been added and plans are filtered by the Pharmacy, a notification will display at the top of the page indicating the plans have the selected pharmacy as one of the following:

1. Preferred pharmacy 2. In-network pharmacy 3. In-network and preferred pharmacy

The pharmacy filter can be edited in the filter settings on the left side of the page.

Preferred Pharmacy: A “preferred” pharmacy refers to a retail pharmacy within a plan’s network that agrees to charge plan members for covered prescription drugs at a reduced copay or coinsurance. In-Network: Medicare drug plans have contracts with pharmacies that are part of the plans “network”. A plan might not cover drugs if the pharmacy is not in the plan’s network.


Add or Edit Doctors & Prescription Drugs

Doctors and Drugs can be added or edited.

ADD OR EDIT DOCTORS When Doctors are added, each plan will display Doctor Coverage. To add Doctors, click Add Your Doctors or My Doctors.

1. Enter the Doctor’s city or Zip code

2. Enter the Doctor’s name

3. Click Add Doctor to add the Doctor to Your Doctor List


4. Click Add Another Doctor to add additional Doctors or click See Plans to review plans

Doctor Coverage will be displayed for each plan with the number of Doctors covered.

If the Doctor is covered, a check mark will display.

If the Doctor is not covered, the doctor name will appear in gray without the checkmark.

ADD OR EDIT PRESCRIPTION DRUGS

When Prescription Drugs are added, each plan will display Drugs Covered and Potential Rx Drug Costs. To add Prescription Drugs, click Add Your Drugs or My Drugs.

1. Enter the name of the drug and select the drug


2. Enter the Dosage, Quantity, Frequency

3. Click Add Drug

4. Click Add Another Drug to add additional drugs or click See Plans to review more plans

Drugs Covered and the Potential drug costs will be displayed for each plan.

Drug Coverage will be displayed for each plan with the number of drugs covered. If the drug is covered, a check mark will display. If the drug is not covered, the drug will appear in gray without the checkmark.


Potential Rx Drug Costs is a monthly estimated amount based on the out-of-pocket expenses you may expect to pay in a calendar year for medications that are not covered by an insurance plan’s formulary on estimated retail drug price (retail drug cost is based on national averages for a medication and assumes adherence).

Plan Details Medicare Advantage Plans display the Plan Name, Monthly Premium, Primary Doctor Co-Pay, Specialist Co-Pay, Drugs Covered, Doctor Coverage, and Plan Features. Medicare Part D Plans display the Plan Name, Monthly Premium, Preferred Generic Drug Co-Pay, In-Network Deductible, Potential Drug Costs, Drug Coverage, and Pharmacy In-Network or Preferred Pharmacy Pricing.


PLAN OVERVIEW

Plan details can be viewed by clicking Show plan overview.

Coverage Highlights, Prescription Drug Coverage, and Other Coverage Highlights will be displayed. Coverage Highlights includes the Star Rating, Annual In-Network Deductible, Out-of-Pocket Maximum, Office Visit for Primary Doctor, Office Visit for Specialist, Inpatient Hospital Coverage, and Prescription Drug Deductible.

PLAN DETAILS Additional details can be viewed for a plan by clicking See all plan details. Benefit Highlights, Drug Coverage, Doctor & Hospital Coverage, and Plan Brochures will display.


BENEFIT HIGHLIGHTS

If Doctors and Prescription Drugs have been added, Personalized Benefits will display at the top of the page. The Plan Coverage Overview details the Plan Type, Annual In-Network Deductible, Out-of-Pocket Maximum, Office Visit for Primary Doctor, Office Visit for Specialist, Inpatient Hospital Coverage, Prescription Drug Coverage, Prescription Drug Deductible, and additional benefit highlights.

DRUG COVERAGE

If Prescription Drugs have been added, prescription drug costs and savings will be calculated based on the plan’s formulary for the prescription drugs. Annual Drug Costs will display individual and Total Drug Costs.


Initial Coverage, GAP Coverage, and Catastrophic Coverage details will also be available.

DOCTOR & HOSPITAL COVERAGE

If Doctors have been added, Doctor coverage will be display. Medical and Hospital Coverage and Additional Coverage details will also display.


POTENTIAL DRUG COSTS

If Prescription Drugs have been added, estimated drug costs and coverage levels can be viewed for a plan by clicking Potential Drug costs. Estimated Prescription Drug Costs and Savings for the Plan will display with a summary of medications and coverage. Added Prescription Drugs will display with Plan Coverage, Annual Costs, and Annual Savings estimates. Plan Coverage will display Prescription Drugs as Covered, Not Covered or Covered with Restrictions. To view additional details for Prescription Drugs that are Covered with Restrictions, such as Quantity Limits or Prior Authorization, click the tool tip next to drugs that display Covered with Restrictions. Details of monthly drug cost and savings will be displayed with the Plan Coverage Level by Prescription Drug.


Prescription Drug cost will be calculated based on the 4 stages of coverage – Deductible, Initial Coverage, Coverage Gap, and Catastrophic Coverage.

PLAN BROCHURES

Plan Brochures are available at the bottom of the Plan Details page.


Compare Plans To compare Plan Details, patients can select up to three plans to Add to compare list.

When using FastQuote to compare plans and email or print plans from the compare page, only present the first three (3) plans displayed on the compare page, or have the patient choose the plans to be compared. If the consumer indicates he/she is not interested in a particular plan and/or carrier, that plan and/or carrier can be excluded from the compare selection if it appears in the top three (3) plans. Any selection of carriers and/or plans that are not included in the top three (3) plans displayed via FastQuote may only be altered at the direct request of the consumer.

When plans have been selected to Add to compare list, the plans names will display at the bottom of the page. Click Compare to compare plans. Side-by-side Plan Details will display for all plans selected to Add to compare list.


EMAIL OR PRINT PLANS

To email a link to the plan comparison, click Email and the local email client will appear for the email to be sent. To print the plan comparison, click Print.

MARK PLAN REVIEW AS COMPLETED

Once you finish the plan comparison, be sure to go back the patient profile to mark it as completed and document the results. See In the Patient Medicare Profile (page 9) for more details.

Date post:	17-Oct-2020
Category:	Documents
Upload:	others
View:	2 times
Download:	0 times

PrescribeMedicare User Guide...PrescribeMedicare User Guide 9.0 11 In the Patient Medicare Profile...

Documents