Don't Automatically Switch Rejected Claims to Cash

April 2015

You'll see more focus on handling "drug not covered" rejections...since the list of non-formulary meds is expanding.

Rising Rx costs are forcing some payers to tighten their belts...charge higher co-pays...or stop covering some meds altogether.

Patients who skip or halve doses on their own to save money might not get adequate treatment.

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Table of Contents

Insurance Don't Automatically Switch Rejected Claims to Cash
Look to See WHY a Patient is on Farxiga or Fetzima
Insulin Clarify Whether Rxs Written as "Insulin Glargine" are for Lantus or New Toujeo
Thyroid Disorders Follow Your State Laws and Pharmacy Policy When Substituting Levothyroxine
Vaccines Watch for Mix-Ups Between Gardasil 9 and Gardasil
Pregnancy Stay Alert for Insulin Dosing Changes During Pregnancy
Smoking Cessation Include All "Titration" Instructions on Chantix Rx Labels
Side Effects Listen for Patients Complaining of Weight Gain With Meds
Elderly Patients Keep an Eye Out for OTC Meds That Can Cause Mental Confusion
Statins Look for Erratic Refills With Statins
Communication Repeat Back the Info You Hear on Prescriber Phone Calls
Practice Ensure All of Your CE Hours Are Now Tech-Specific