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In order to be eligible for the Xeljanz MasterCard Debit Program, one must first_____________

Be enrolled in the Xeljanz Co-Pay Card Program

Be enrolled in the Xeljanz Base Card Program

Be enrolled in the Xeljanz MasterCard Debit Program

Be enrolled in the Xarelto CarePath Base Program

Sonexus Health/XelSource will enroll the patient after completing a benefit investigation.

True

False

The medication xeljanz is used for ______________

Asthma

Anaplastic thyroid cancer

Acromegaly

Rheumatoid Arthritis

Who will call to enroll the patient into the program?

The patient

The prescribing physician

Sonexus Health/XelSource representative

LASH representative

What is the first step within PLP to enroll a patient into the program?

Add a New Person

Enrollment

Person

Administration

What is the second step within PLP to enroll a patient into the program?

Find a Person

Initial Enrollment Processing

Work with a Person

Unlock Documents

What information do we need in order to process enrollment?

Patients name, DOB, address, member ID number

Patients name, DOB, address, telephone #, member ID and initial load amount

Patients name, DOB, address, telephone #, member ID, (optional e-mail), and initial load amount

Patients DOB, address, telephone #, member ID, (optional e-mail) and initial load amount

Once the patient is enrolled, within 7-10 business days they will receive.....

Prepaid MasterCard, welcome letter and PIN mailer

Prepaid MasterCard, welcome letter, card holder agreement and proof of purchase form

Prepaid MasterCard, welcome letter, card holder agreement, proof of purchase form and PIN will be mailed separately

Prepaid MasterCard, welcome letter, card holder agreement and PIN will be mailed separately

How long will it take to process enrollment ?

2-3 business days

5-7 business days

7-10 business days

7-14 business days

What are the two types of Gemini Tickets we would create for this program?

Enrollment Issue and Claim Issue

Appeal and Claim Issue

Appeal and Lost Card

Enrollment Issue and Appeal

This program is designed to financially assist those for_________treatment

Fertility

cancer

flu

dermatological

This EMD Compassionate care program will cover the medications:

Gonal F, Ovidrel and Clomid

Gonal F, Clomid and Lupron

Gonal F, Ovidrel and Cetrotide

Ovidrel, Clomid and Cetrotide

What other documentation must be submitted along with the enrollment form in order to process the application?

PCA and most recent 1040 tax document

PCA and W2 (or paystub)

most recent 1040 tax document and W2 (or paystub)

most recent 1040 tax document and letter

What are the three ways one can submit their application?

On the phone, complete on website or fax

They can drop it off to us, complete on website or fax

Complete on website, Call, or drop off to us

Complete on website, fax, or mail

What documents do you needs to submit to get a rebate?

Detailed EOB or Specialty Pharmacy

Itemized Bill Only

Cash register receipt

How long does it take to process a claim?

5-7 business days

1 business day

2 business days

How long does it take to process a claim?

Regret Letter

Clarification Form

Out of Network Verification Letter

If a patient wants to change their payment method what needs to be done?

This must be approved by the client, then submitted to programs SCR

Submitted to programs SCR

This must be approved by the client, submitted to programs SCR, following questions must be answered why the patient needs to switch? Has the patient already paid for the drug out of pocket?

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