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Official Course
Description: MCCCD Approval:
4-27-04 |
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CSR137
2004 Spring – 2009 Summer I |
L+L |
3.0 Credit(s) |
4.0 Period(s) |
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Pharmacy
Benefit Database Management |
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Pharmacy
benefits management company database operations. Emphasis on data location,
information documentation, and information security. Covers customer service
and information retention strategies as well as printed pharmacy benefit
policy provision procedures. Prerequisites: None. |
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Go to Competencies Go to Outline
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MCCCD
Official Course Competencies: |
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CSR137 2004
Spring – 2009 Summer I |
Pharmacy Benefit Database Management |
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1.
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Use strategies designed to foster improved information
retention. (I) |
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2.
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Explain the means by which a pharmacy benefits management
company delivers medication discounts to customers. (II) |
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3.
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Employ customer service strategies in the provision of
customer service. (III) |
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4.
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Express pharmacy benefit management company information
security concerns. (IV) |
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5.
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Explain general pharmacy benefit management company
database navigation. (V) |
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6.
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Locate a specific member record within a database. (VI) |
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7.
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Explain the type of customer information represented in
coverage codes. (VII) |
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8.
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Document customer interaction activities in electronic
file notations. (VIII) |
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9.
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Collect member benefit eligibility information from within
a database. (IX) |
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10.
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Arrange for the provision of printed information to
requesting customers. (X) |
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11.
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Identify the estimated amount of time for account changes
to take effect for inquiring customers. (XI) |
Go to Description Go to top of
Competencies
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MCCCD
Official Course Outline: |
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CSR137 2004
Spring – 2009 Summer I |
Pharmacy Benefit Database Management |
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I. Information Retention
Strategies A. Active Listening
Behaviors B. Notetaking
Activities C. Anxiety Reduction II. Medication Discount
Delivery A. Service 1. Mail 2. Retail B. Claim Acceptance 1. Paid Claim Management 2. Rejected Claim
Management III. Customer Service
Strategies A. Beneficial Behaviors B. On/Off Stage Awareness C. Customer Recovery D. Anger De-Escalation IV. Information Security
Concerns A. Patient Information B. Office Security Concerns
C. Customer Identification
Procedures V. Database Navigation
Overview A. Screen Identification B. Search Engine Usage C. Navigation Procedures VI. Member Record Location A. Primary Means B. Secondary Means 1. Personal Information 2. Alternate Account Information
VII. Coverage Code
Information A. Member Coverage B. Coverage Ages C. Membership Card
Requirements VIII. Activity
Documentation A. Legal Considerations B. Field Identification C. Documentation Type
Considerations 1. New Issues 2. Existing Issues IX. Benefit Information
Collection A. Member Profiles B. Eligibility Information
Screen Location X. Printed Policy
Information Transmittal A. Replacement Card
Provisions B. Claim Form Provision C. Preferred Medicine
Policy Information XI. Account Activity
Actualization A. Standard Activity Type
Estimation B. Estimation Provision |
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