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Route to Reviewer II

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Route to Reviewer II
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Tekst Storyboardowy

  • We have been tasked to address concerns with orders placed in the Reviewer queue. Reviewer Techs are also not adding an ERDEF PRADD when necessary.
  • Susan, I have reviewed some of the orders in the Reviewer queue. I am not sure why they were placed there because a name and DOB search pulls up the account.
  • Yeah, most orders in the Failed Fax or Reviewer queue should not be there. I am not sure if the techs are searching for a member number
  • Do you think the techs are reviewing the entire order? Sometimes the patient information is on a different page in the order.
  • You are right Jeff. Sometimes the patient's DOB will not be on the Rx. You will find it on the UOF or a note.
  • What about when the zip code is on the envelope and the Rx has the patient's name. A search can be done using the zip code on the envelope and the patient's name.
  • Keep in mind, there are times when orders should be placed in the Reviewer queue.
  • Reasons to Route Fax Channel Large Orders (more than 17 Rx's) -route to ResearchMail and POC Verbal Channel select Disassociate RequiredLarge Orders (more than 17 Rx's) Multiple members in order and patients have separate accounts
  • Return orders to the prescriber or patient when an account is not found.
  • Reasons to Return Orders to Prescriber or Patient After performing all searches:Member not Found (MNF)Not Enough Qualifiers (NEQ)Fax back to Prescriber when working Fax, Verbal or POC ChannelReturn to Patient when working Mail Channel
  • Don't forget to remind Reviewers to add an ERDEF PRADD when a member number can be located for orders in the Reviewer queue. The ERDEF will ensure we provide feedback to techs who are routing unnecessarily.
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