Commercial/Medicaid BCR Issues PDF
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This document provides an overview of commercial and Medicaid BCR issues, including request types, and procedures for handling calls. It's a guide for handling complex cases for commercial, Medicaid, and Medicare Part D lines of business.
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TRAINING KNOWLEDGE BYTES Commercial/Medicaid BCR Issues (BCR Mailbox) OVERVIEW The BCR Queue is located in PAHub and is managed by the Offline Team. The Offline Team is a specialized group of associates who...
TRAINING KNOWLEDGE BYTES Commercial/Medicaid BCR Issues (BCR Mailbox) OVERVIEW The BCR Queue is located in PAHub and is managed by the Offline Team. The Offline Team is a specialized group of associates who handle complex cases over the Commercial, Medicaid, and Medicare Part D lines of business. BCR Request Types for Phones: 1. Commercial Copay Exception Requests 2. Commercial/Medicaid Eligibility Issues 3. Commercial/Medicaid Manually Added Member pop-up issues 4. Commercial Copay Exception Requests 5. Commercial Admin Question Directed Override (VA and ME Only) Prescriber initiated: 1. The call must be warm transferred to the BCR Phone Team using the internal extension Display Name OnCloud VQ Prior Authorization, BCR Commercial CLRX_PA_BCR_Commercial_Retail_Transfer Prior Authorization, BCR Medicare CLRX_PA_BCR_Medicare_Retail_Transfer Prior Authorization, BCR Medicaid CLRX_PA_BCR_Medicaid_Retail_Transfer Member Initiated: 1. Keep Caller on the line and fill up Mailbox form. 2. Advise that the request has been sent to another dept that would work on their case and they should keep their lines open because another representative will be reaching out to them for other pertinent info that maybe needed to build the case. Reference:
