Communication should be conducted with professionalism through
- telephone
- letter
- email
- faxes
- electronic formats
- mobile devices (e.g., text messages).
See ASHP 3.14.
Process/Skill Questions:
- What are common reasons for rejected claims?
- What are the most common prior authorization procedures?
- How would a pharmacy technician communicate with patients, third-party payers, and others regarding medication coverage?
- How does HIPAA limit what information may be communicated to the patient regarding rejected claims and cancelled policies?
- What is the pharmacy benefits manager’s role in the adjudication of claims?
- What is the pharmacy benefits manager’s relationship to a third-party payer?