DecisionHealth, DecisionHealth - 2006 Issue 5 (May)
Surviving Part D: Pharmacists can be your allies
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Article Overview
This short article discusses office workflow challenges related to Medicare Part D prescription coverage, formulary checks, and pre-authorization communication. It is aimed at physicians, practice managers, billing staff, and pharmacy-facing office teams that handle prescription access questions and coordination with pharmacists. The piece focuses on general operational guidance for determining plan coverage and responding to coverage-related pharmacy calls.
Why This Topic Matters
Understanding Part D coverage and pre-authorization steps can help practices reduce delays when patients need medications and improve coordination with pharmacies and plan information sources.
What You Will Learn
- How Part D coverage questions can affect prescription workflow in a medical practice.
- Why pharmacies may become involved in identifying a patient’s drug plan and coverage status.
- What general factors practices may check when a medication may need approval or has urgent clinical importance.
- How online plan resources can be used at a high level to review formulary and coverage information.
Who Should Read This
- Physicians
- Practice managers
- Billing staff
- Office staff
- Pharmacy coordinators
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