Wednesday, March 24, 2010

BCBSNC introduces new call program for groups with pharmacy benefits

Effective March 31, BCBSNC is implementing a new outbound call program for group members with BCBSNC pharmacy benefits. The program aims to improve medical adherence and reduce plan costs by encouraging generic and mail order utilization and providing expertise and advice on prescription drugs.

Members meeting the criteria outlined below will receive calls from the Therapeutic Resource Center, a group of pharmacists and benefit specialists employed by Medco, beginning March 31.

Phone call criteria
• Members taking 3 or more maintenance medications AND
• Have been diagnosed with Cardiovascular Disease, Pulmonary Disease, Neuro-Psych Disorder, or Diabetes or are taking a Specialty drug
• Members with adherence issues or omissions of therapy issues
• Members who are new to a therapy

Outbound call process
• Pharmacists/benefit specialists will identify themselves as “Medco calling on behalf of BCBSNC,” will address members’ questions/concerns regarding their medication and will remind members of the advantages of using mail order to purchase a 90-day supply
• If a benefit specialist is making the call, they will ask if the member would like to speak to a pharmacist at the beginning of the call
• Pharmacists can address side effects and safety concerns, in addition to general questions about the medication

Specialty drugs
Specialty drugs are those that generally have unique uses, require special dosing or administration, are typically prescribed by a specialist provider and are significantly more expensive than alternative drugs or therapies. They are generally considered high-cost injectable, infused, oral, or inhaled drugs that require close supervision and monitoring.

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