Transcript Member Eligibility Tutorial

Interactive Drug Search
Application Tutorial
All Content ©2006 Health Alliance Plan
Overview
The Interactive Drug Search application allows Providers, Members,
Agents, Employers and Guests to view detailed drug information
such as member specific co-payment or tier placement of drugs,
preferred drug alternatives as well as typical dosage forms and
strengths, usages and other therapeutic guidelines.
• This tutorial will explain in detail how to use the Interactive Drug Search
online application to obtain drug information.
• The diagram below provides an overview of the tutorial’s flow from page to
page. The links on the diagram can be used to navigate directly to a specific
page found in this tutorial.
• A smaller version of this diagram can be seen throughout the tutorial in the
upper left-hand corner with one region shaded, in order to note which page
you are on in the process. To navigate backwards and forwards in this
tutorial, click on the appropriate chevron in the upper left-hand corner of the
following pages to jump to the desired section of the tutorial.
Interactive
Drug
Search
Overview
Member
Contract
Selection
Drug
Search
Members
Drug
Search
Providers
& Guests
Search
Results
Search
Results
Summary
Guest
Search
Results
Summary
Provider
Search
Results
Summary
Member
Drug
Detail
Drug
Cost
Info
Recalculate
Conclusion
Drug Cost
2
Member Contract Selection
The Member Contract Selection page allows you to select the Member and contract for which
you wish to view eligibility and benefit information. This page will only display for members
with dual HAP coverage.
To view the workflow and topics
that may be of help to you
throughout the process of using
the Interactive Drug Search
application, click on the Help
link. Help is available on every
page within the Interactive Drug
Search application.
To view what is new with
the current version of the
application, click on the
What’s New? link. This
link is available on all
pages within the Interactive
Drug Search application.
If you are the contract
subscriber, you may select to
view information for yourself or
any dependent under the age of
18 covered under your
contract(s).
To view drug
information for a
particular Member, click
on the Member Name
under the desired
contract.
If you have multiple contracts
with HAP you may select the
contract for which you would
like to view benefit information.
To submit a question
regarding this application to
HAP via the online, go to
the Help and click on the
How To Contact Us link.
3
Drug Search (Members)
The Drug Search page allows HAP guests to enter drug search criteria.The drug name or a selected
drug category is required to initiate the drug search.
In addition to enabling the
drug search functionality, the
member’s name, group
name, copay or coinsurance
information is also
displayed.
Enter your selection
criteria.
You may search for a
drug based on drug
name or treatment
category. To select by
drug name, you are
required to enter at
least 3 characters of the
drug name.
If deductibles are applicable
to your coverage, either a
YES or NO will display here
indicating if a deductible has
been met. N/A indicates that
deductibles are not
applicable to your plan.
ACE
Once your selection
criteria has been
entered, click on the
Search button to
initiate your query.
Please refer to the Help
documentation for detailed
information about how this
information is determined.
4
Drug Search (Providers & Guests)
The Provider and Guest Drug Search page allows Providers and Guests to enter drug search. The
drug name or a selected drug category is required to initiate the drug search.
Enter your selection
criteria.
ACE
You may search for a drug
based on drug name or
treatment category. To
select by drug name, you
are required to enter at
least 3 characters in the
drug name.
Once your selection
criteria has been
entered, click on the
Search button to
initiate your query.
5
Search
Results
The Search Results page displays all drugs that meet your selection criteria. In this example, all
drugs beginning with “ACE” display.
If the drug you are looking
for is listed, click on the
Drug Name to proceed to
Search Result summary
information.
If the drug you are looking
for is not listed, select
Drug Search link located
on the left Navigational
menu to enter new search
criteria.
6
Search Results Summary (Guests)
The Search Result Summary page displays valuable information about your selected drug,
including whether the drug is branded or generic, a preferred drug, or a maintenance drug. If
authorization is required for the drug, this information is also provided under coverage notes.
The printer friendly
icon appears on several
pages within the
Interactive Drug Search
application. By
selecting this Printer
Friendly icon, the page
will be formatted to
print on 8 ½ x 11 inch
page.
Here is an
example of the
pop up text for
Preferred Drug
column heading
link is selected.
The guest may obtain a
definition of the column
headings by clicking on
the various links.
The pop up text
descriptions are
available to all user
types (guests, members,
providers, etc…)
Search Results Summary (Providers)
This version of the Search Results summary page will be displayed to registered vendors
and providers. The provider version of the page allows the provider to “price” the drug
based on HAP discounts and an average wholesale prices.
Copay Tiers are
displayed for
Providers and Vendors,
Tier 1 drugs are
Generic, Tier 2 are the
Preferred Branded and
Tier 3 are NonPreferred Branded
drugs.
Drugs that are
identified as Preferred
or Maintenance Drugs
will be identified by
an orange check mark.
If there are any
alternative drug
recommendations to
the drug you search
for, they will display
on the Search Results
summary page as well.
8
Search Results Summary (Members)
This version of the Search Results summary page will be displayed to registered members.
The member’s version of the page allows the member to price the drug based on HAP
discounts and an average wholesale prices.
The Member Search
Results summary page is
similar to the the
Providers version, except
that Copay dollar amounts
are displayed.
Drugs that are
identified as Preferred
or Maintenance Drugs
will be identified by
an orange check mark.
If there are any
alternative drug
recommendations to
the drug you search
for, they will display
on the Search Results
summary page as well.
9
Drug Detail
The Drug Detail page is available to registered HAP users. The Drug Detail page displays
useful information including the drug uses, side effects, precautions and drug interaction
considerations.
To obtain detailed
The
Available Strengths
information
about a
anddrug,
Dosage
Form
page
select the drug
displays
strengths
and
name from
the Search
forms
for your
Results
page.selected
drug. (I.E. tablet,
capsule, syrup, inhaler)
Select the drug strength
and form that meets your
After you’ve selected
criteria.
the drug name, the
Available Strengths
and Dosage Forms
page will display.
You may return to
the previous page
by selecting the
Return to
Summary link.
10
Drug Detail
The Drug Detail page is available to registered HAP users. This page displays useful
information including the drug uses, side effects, precautions and drug interaction
considerations.
To close the Drug
Detail page, click
on the Close
Window button.
11
Drug Cost Information - (Members)
The Drug Cost information page displays various prescription drug costs related to the
Members HAP benefits including estimated HAP Member, Mail Order and Retail costs.
The Drug Cost Information
page will display.
The member may select
one of the row headings
below to obtain a detailed
description of the cost
associated with the drug.
In this example the
Member has selected the
Estimated COPAY row
heading.
A pop up text box
will appear.
A typically prescribed quantity is
used for the cost calculations. If
however, you know your exact
prescribed amount, you may
select “Recalculate Drug Cost”
to customize the drug quantity.
To obtain Drug Cost
information, select the
$PriceIT Link from the
The member
select
Search may
Results
page.
the drug name which will
direct the user to the
Drug Detail page
The member may view
estimated cost
information based on
HAP’s discount rates and
information from an
independent cost
information supplier
To return to the
Search Results
summary page
click here.
12
Recalculate
Cost
The Recalculate Cost page allows the user to change the drug quantity and obtain a drug cost
that reflects their prescription.
To recalculate the drug
cost, enter the Revised
Quantity, and click on the
$Price IT link.
The Drug Cost
information page will
redisplay with the revised
drug costs.
If you change your
mind and do not wish to
revise the quantity,
select the “Back to
Drug Cost” link to
return to the Drug Cost
Information page.
13
Interactive Drug Search Application
Tutorial Conclusion
This concludes the Interactive Drug Search
Application tutorial. To revisit a topic,
please go to the Overview by clicking the
diagram in the upper left hand corner of this
page. Otherwise, click once to close this
tutorial.
Contact Us if you have additional questions
related to updating your contact
information.
14