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what hello this is Brett Bowers I am the.marketing manager for tml multi-state.intergovernmental Employee Benefits pool.and I'm glad you joined us today I want.to welcome you to this edition of the.teach and learn tutorial and I'm excited.in this tutorial we're actually going to.learn how to understand and make best.use of your presentation.you.Bauer's and I'm the marketing manager.for tml multi-state intergovernmental.employee benefits pool and I am very.excited that you joined us today and I.want to welcome you to this edition of.the teach and learn tutorial in this.tutorial we're gonna learn how to.understand and really just make best use.of your prescription drug plan and.online resources that are available to.you so we're going to spend about five.or ten minutes together there's a lot of.information to cover but what we're.hoping to accomplish by the end of our.time spent is we're going to take a look.at the utilization I'm sorry how to.utilize the medication therapy.management guide and that is an online.resource that is created annually by EBP.and really it is the Bible or the basic.101 and encompasses every single thing.related to your prescription drug.program now included in that guide and.as part of the information we will.review today we're going to discuss the.formulary for those of you that aren't a.high deductible health plan attached to.a health savings account we'll want to.discuss and understand the Wellness drug.list we will also take a look at.specialty drugs what they are and how.they're accessed as well as mail-order.and while the guy is great and it's.really the first place you want to go to.get information on your prescription.drug plan we also have some online.search tools available to you that will.assist you when you need information.that is real-time and we're going to go.online to optim-r XCOM and take a look.at how to look up a pharmacy where do we.go to do that online and then we can.actually go and do some drug pricing so.that if you know that you need a.prescription drug you can find where the.most cost-effective store is for you to.find that drug or you may be interested.in a lower-cost alternative that is in.that same therapeutic drug class and.then of course we're going to tie it all.together online by taking a look at your.benefit or you can see specifically.based upon your utilization and your.co-pays through the.what a mouth has been satisfied on your.deductible and in the federal maximum.out-of-pocket and we will talk in detail.about that so it's going to be a.complicated teach and learn tutorial.only because there's so much information.and we're going to use sometimes we're.going to go online and we're going to.look real-time and then other times.we're going to go back to the PowerPoint.and look at screenshots but we put it.together so that we can get through as.quick quickly as possible and give you.the most bang for your buck again our.goal is to be completely transparent and.to give you the tools and the.information that you need so that you.can get the care that you need and you.can do so in the most cost effective.manner so on your mark instead let's go.let's first go online and I'm going to.open this up.I am already logged in to our website at.www.ge.com prescription drugs this is.the screen that's going to pop up now.include it in here you will see is the.medication therapy management guide.that's where we want to spend the first.four three or four minutes just kind of.again we can't drill down real deep but.boy we can get a lot out of the four or.five minutes where together we're going.to look at the medication therapy.management guide and then once we get.through doing that we're going to look.at the optim-r X website where you can.get some real-time information that will.be very handy for you so if there's a.delay it's because my computer's full of.stuff so let's click on it and see how.long it takes to get us there I am.alright we're good so this is the.medication therapy guide and the.medication therapy guide again the.management guide is it's pretty big so.let me give you a trick and show you how.I like to navigate it if you click right.click on the document and put show.navigation pane buttons and all of a.sudden I now have a thumbnail view of.all of the pages that are in this guide.and if I go to page two then I'm going.to look at the table.it's now the first thing I want to do is.just have an understanding that all of.the prescription drugs are on a.formulary and a formulary is going to.differ from plan here to plan here it's.going to differ from one company to the.other so it's as we begin to look at.this just to understand it really is.just taking a bird's eye view at all the.prescription drugs and then with each.drug it talks about the corresponding.peer that is listed to list not talk.about it let's look at it so let's look.at the formulary and let's find that on.here and there you go if you click on.this right here look it's going to.automatically take you down to that.specific topic within the big guy and as.you look at your various prescription.drugs that are listed in the formulary.you can see that there's a corresponding.drug tier so what is a drug tier well up.here on the top you'll see that we have.a handy kind of grid that essentially.tells you what could simply be said the.lower the tier the lowers your.out-of-pocket cost so if you see a drug.it is a Tier one drug that means that.that prescription drug has the least.out-of-pocket cost for you and your.family to access that medicine typically.it is going to be one of your no cost of.merit drugs or a name brand drug if.however you see tier two that.prescription drug is somewhere right in.the middle between one and three so.three means it's the highest costing.drugs and in our prescription drug.program those high end cost drugs could.cost anywhere from sixty dollars up to.one hundred and twenty dollars but.understand if there is a drug that is in.a tier three category there will be a.Tier one or a tier two drug available in.the same therapeutic class and so this.whole formulary is designed so that you.can just quickly take a look at it and.get an idea of what the prescription.drugs cost as it pertains to what here.they fall into so we're going to take.we're going to go back now I'm going to.go back over to the thumbnail.I'm gonna scroll all the way back up.because I want to get to that in the.table of contents so now I'm at the.table of contents let's talk about the.high deductible health savings account.benefit plans so if you are on a high.deductible health plan that is attached.to a health savings account then you.know that you need to definitely.appreciate this list and understand the.prescription drugs that are available to.you on this wellness droid list now if.you're not on a high deductible health.plan attached to an ASA HSA this does.not apply to you so you can just kind of.tune me out for about 30 seconds but if.you're on that high deductible health.plan these are the lists of the.prescription drugs that are available to.you at the copay level and that copay is.available to you prior to the deductible.being satisfied.so once the deductible satisfied of.course you get the benefit of a copay.for all your prescription drugs but if.you're on a high deductible health plan.you'll want to make certain if your drug.is on here then you'll know that you'll.get the benefit of maybe it's a no cost.an air drug or maybe it's one of the.co-pays otherwise if you do not see your.prescription drug on this list then you.will simply pay for the cost of the drug.but that entire cost will be credited to.your deductible so it really doesn't.work to your benefit either way okay so.that information is in here this is.updated annually the high deductible.health plan wellness list does not.change throughout the year so let's go.all the way back up to three now I'm.sorry - we're gonna go back to that.table of contents and now I want to take.a look at the specialty prescription.drugs and so let's see if we can't find.that in here.and there we go there's an optimal.specialty biotech pharmacy and so what.you'll see here again is a very.high-level view of the biotech.prescription drugs that are available.within our plan now some specialty drugs.will require prior authorization and you.can see those will be noted by the.asterisk right here some have the aster.which means prior off.required whereas others do not have an.answer which means there's no prior.ultra-quiet.and I would like to point out that there.are some of the prescription drugs that.presently are listed but they are.ineligible and they would not be covered.by the medication therapy management.program so let's just talk about now how.does one access biotech prescriptions.we've got some great information up here.and so all the numbers that you.potentially could need would be listed.right here within the guide but simply.put to get access to a biotech.prescription drug your prescriber or.your physician would contact our X.results and that number is right here.and they would do so that information is.also on the back of your ID card so even.though your provider probably doesn't.have this awesome guide they do have the.ID card they would call our X results.once it's approved then you would.receive a phone call from our X results.to set up your profile or what might be.better as you can call this number right.here and you could set up your profile.as well and what does that profile do it.literally just talks about you know.where are you your mailing address and.and verify the shipping instructions.such as whether the medication should go.to the prescriber or the position or.whether you want it to go to your house.now yes that authorization is not upheld.oftentimes more clinical information is.needed from your provider in order to.validate whether it's evidence-based.medicine if it is denied you will.receive a letter in the mail and so will.your prescriber so for the specialty.that is the way the process works again.it is all done primarily through your.provider but you would need to set up a.profile with optim-r X and they will.even call either call you to do that or.you can proactively call them and get.that set up there are also biosimilars.and so in the same way that you can get.a brain a brand name drug versus a.generic drug more and more biosimilar.drugs are being introduced in the.biotech category so the biotech copay is.typically $100 copay and if it's a.biosimilar drug or a generic biotech for.most of the plans it's a $75 copay but.again you will have to check your.specific prescription drug plan if.you're with a employer that is not part.of the pool it has a different copay.okay we're going back over here to the.left let's go back to our table of.contents and let's look at the last.thing I want to show you that is the.mail order.so for mail order service you see I.clicked on that it's going to take me.right down here there is a prescription.mail and order form so you can just.simply fill that out and you can fax.that information and the fax number is.right down here or I'm going to show you.next how you can do that information.online without ever having to lift a pen.or a pencil so let's take a look now at.the online access and search tools that.are also available through Optima EX.because you can certainly fill out the.mail order form with the form or you can.convert and you can go online in real.time and access that information as well.again your medication therapy management.guide is by far your greatest tool to.understand your prescription drug.program we hit very high level if you.have any questions feel free to contact.your marketing representative or if you.have a specific question about a.specific drug certainly you can call.contact our customer care we will help.you in any way shape or form that we can.okay.we're moving on to the next thing let's.take a look at online access so now what.I'm going to do let's pull up the.PowerPoint we had and let's move forward.towards the optimum rx website so one.thing that you will need to understand.is you can always go to optim-r XCOM and.access your information through their.webs.site but you can also access that.information through our website so.here's how it works let's go back real.quick I want to show you do I want to.show you yeah it's not gonna let me I.don't know what I just did but I sure.made a big didn't see if I could go back.down okay so let's go back to when you.go to optim-r X I showed you at the.beginning where there's the medication.therapy guides and it also says optim-r.X single sign-on so the first thing you.need to do to get online access to the.optimum RX website is you need to.register with.Optim Rx and you're going to do that on.the Optim RX website and again that's at.www.irs.gov.you register you will receive a.confirmation email you will click on the.link and then this is the screen that.will pop up so in order for you to.officially register your particular.prescription drug program that you have.with IVP so you can extract that.information that's customized to your.plan design you're first going to need.to put in your member ID now your member.ID can be located by looking at your.prescription I'm sorry your medical ID.card and there at the very top right it.will say unique identification number.now we are getting new cards and they.are going to actually be a lot simpler.and there's not going to be near as much.information on it so it may look a.little different than what you have.exactly right here but it will still.have on the top right the unique ID.number and so when you go to the Optima.EX website to complete the registration.process you're going to put in your.member or unique ID right there where it.says member ID number.you're gonna fill and all that.information and then once you do that.you will be able to log in to the Optima.EX website so that's the confirmation.email that they gave me I clicked on.that and it took me to that next side.now because I've went ahead and.registered with optim-r XCOM directly.now when I drop down to my my hub with.IBP and I click on prescription benefits.now I just have to click on that optim.rx single sign-on so I don't have to.leave this site and go to the other side.I will warn you because we are seeking.up the information and literally moving.from one site to the other with a single.sign-on.it does take a little time to load so.don't get frustrated if you're sitting.there for 12 seconds because it has.taken as long as 30 seconds for it to.move over and then other times for.reasons I don't understand it's taking.two seconds but do know that there could.be some latency in that so now that.we've logged on to the optimal single.sign-on here's what you're going to see.and so this is a snapshot I have taken.it exactly off the BOK demarks and i.want to walk you through some of the.online tools that are available to you.so the first thing is how to locate a.pharmacy and because we're doing.screenshots and because this is.extremely intuitive and very user.friendly it really does not require a.tutorial right here where it says locate.a pharmacy you will type in your zip.code and then literally it will pull up.a list of all the various pharmacies.that are available for you now you.remember one of the things we were.talking about what we were looking at.the medication therapy management guide.was the mail order and so even on the.very front screen the home screen you.will see that if you want the options.that are available to you not only with.price and convenience for the optimum.prescription mail-order program you can.do all of that online as well as manager.refills or manage renewing any.medications that have expired so this is.a pretty neat dashboard of information.that you that you might find helpful now.there's a lot of stuff in here but I.really because of our time and really.because of the impact and the importance.of this I just want to walk you through.two specific parts of this website that.I think are most helpful to our.membership and allowing them to.understand and get the most out of the.prescription drug program so drug.pricing and alternatives I.going to click on that and then this is.going to pop up now let's say a high.blood pressure medication is called Abba.Pro and so I know that the prescription.drug that I'm taking I'd like to get the.drug pricing on that and see if there.any alternatives to that prescription.drug so I've already typed it in then.down here I'm gonna hit Search BAM it's.gonna pull up right for me as you can.see here's the Abba Pro that I did a.search on and for the pharmacy located.closest to me it would cost 135 dollars.of 92 cents now again your numbers might.look a little different the example that.is being shown here is on a high.deductible health plan so you might have.a thirty-eight dollar copay or a sixty.dollar copay the great thing about the.optim-ox website is it's attached to.your eligibility and your custom.prescription drug program and so it will.be customized and accurate for you and.your family but whenever that cost is.once you put it in if there are other.lower-cost.alternatives to the drug that you did a.search on that you can see it will list.what those other prescription drugs are.and what the corresponding costs are and.so that's where this becomes very.impactful as you try to manage your.out-of-pocket cost and again you would.certainly need to communicate with your.provider to make certain that a changed.and that prescription drug and the.script that was written is appropriate.but it's nice that you have complete.transparency and you know all your.options so I'm going to go back again.that was in the drug pricing and drug.pricing alternatives and you can type in.any drug that you are aware of our good.list or get off the formulary.and type that in there and you will get.the same format of information the drug.that you did a search on and then any.lower-cost.opportunities for a switch to a similar.drug and the therapeutic class as long.with the cost at specific pharmacies the.next thing I want to touch on with the.optimum rx online search is there's a.tab here you can see we've got it in a.red circle Europe and.now one of the things that has become.part your prescription drug program this.year and it's embedded so it's nothing.that you asked for that you may even be.aware of but there is now a new feature.for your benefit package which is called.the federal maximum out-of-pocket and.you know before if you were on a.traditional PPO every time that you.purchased a prescription drugs and let's.say it was a thirty-eight dollar copay.that was a great cost for a prescription.drug that could cost two hundred dollars.but you know that thirty-eight dollars.didn't go anywhere.that thirty-eight dollars was not.credited to your deductible similarly if.you had an office visit copay it's great.that you could pay you know a thirty.dollar office visit copay and not have.to pay for the full build a mound of a.hundred dollars but again that $30 copay.was not going anywhere well with the new.structure set forth by the Accountable.Care Act there is now something called.the federal maximum out-of-pocket and if.you click on this here where it says.your benefits you will get a snapshot of.those co-pays are now accumulating to.the maximum out-of-pocket and so that is.the number that is listed there and.again your numbers will look different.because the plan that is being.represented here is a high deductible.health plan but your numbers likely.would be half of this but you will see.every single time a prescription drug.co-payment is met there is credit given.to the maximum out-of-pocket and so if.you have questions about that again that.is a very very simplistic version of.what could be a very very complicated.benefit but it really is not a takeaway.it is to your benefit and it simply says.that your co-pays now are being credited.if at any time you make enough.out-of-pocket cost those co-pays that.are the most cost effective Network.eligible benefits will be credited to.your maximum out-of-pocket and if your.deductible and your playing out of.pocket in the federal maximum.out-of-pocket.up to that maximum threshold then the.plan will kick in and pay at a hundred.percent okay so that kind of summarizes.at a very high level Cliff Notes version.of how to understand and get the best.use out of your prescription drug plan.so let's just kind of review some of the.important takeaways the first most.critical thing that you could do that.would be most helpful is take a look at.the medication therapy management guide.take a look at the formulary the high.deductible health plan wellness list and.again those are only for people that.have a plan.that is a high deductible health plan.attached to a health savings account.there's information in there about how.to move forward with biotech drugs some.require prior off some don't your.prescriber or your physician will call.rx results and they'll do so and you.will be notified if it's approved or if.it's not approved there's information in.that guide about how to do mail-order.you can fill out a form but again there.is a online search tool is available.through WWI optim-r x and we walk.through all of those different tools and.how those to be used real time to locate.a pharmacy to do some drug pricing and.then take a look at your benefits and.how your co-pays are accumulating to.your plan out of pocket or your federal.maximum out-of-pocket again thank you so.much for being engaged and informed.about your healthcare benefits if you.have any questions contact us at.customer care for health at 1-800 to.eight two five two three eight five and.we appreciate you and we thank you and.we hope you have a great day.

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Optumrx Fax Prescription Form FAQs

Discover answers to listed questions about Optumrx Fax Prescription Form . Check out the most popular topics and more.

Need help? Contact support

Why would a doctor send a prescription to a pharmacy, but not respond to repeated requests from the pharmacy to fill out a faxed prior authorization form?

If the cash price of a medicine is <$10 we rarely do a prior authorization. That’s just the insurance company trying to screw everyone over (patient, doctor, pharmacy). Sometimes they send it to the wrong office. Sometimes, despite telling you they did, they didn’t. Sometimes they tell you it isn’t covered but don’t bother to start a prior authorization to see if we can get it.

I want to create a web app that enables users to sign up/in, fill out a form, and then fax it to a fax machine. How to difficult is this to develop?

Are you sending yourself the fax or are they able to send the fax anywhere? The latter has already been done numerous times. There are email to fax and fax to email applications that have been available for decades. I'm pretty certain that converting email to fax into app or form submission to fax is pretty trivial. They convert faxes to PDF's in many of these apps IIRC so anywhere you could view a PDF you could get a fax.

Do military members have to pay any fee for leave or fiancee forms?

First off there are no fees for leaves or requests for leave in any branch of the United States military. Second there is no such thing as a fiancée form in the U.S. military. There is however a form for applying for a fiancée visa (K-1 Visa)that is available from the Immigration and Customs Service (Fiancé(e) Visas ) which would be processed by the U.S. State Department at a U.S. Consulate or Embassy overseas. However these fiancée visas are for foreigners wishing to enter the United States for the purpose of marriage and are valid for 90 days. They have nothing to do with the military and are Continue Reading

Why does it take so long to get a prescription at the pharmacy?

When the pharmacist is filling a prescription, he is first of all writing the label with the doctor’s instructions on it, secondly dispensing the proper amount of medication, affixing a label to the container, and fourth, usually submitting an insurance claim for the price of the drug. The most time-consuming part of filling a prescription is usually the wrangling on the phone with the insurance company. Even if all prescriptions were paid for out-of-pocket (not insurance reimbursed), the sheer quantity of prescriptions to be filled makes it take a long time for them to get to your prescription Continue Reading

How can I fill out Google's intern host matching form to optimize my chances of receiving a match?

I was selected for a summer internship 2016. I tried to be very open while filling the preference form: I choose many products as my favorite products and I said I'm open about the team I want to join. I even was very open in the location and start date to get host matching interviews (I negotiated the start date in the interview until both me and my host were happy.) You could ask your recruiter to review your form (there are very cool and could help you a lot since they have a bigger experience). Do a search on the potential team. Before the interviews, try to find smart question that you are Continue Reading

How do I fill out the form of DU CIC? I couldn't find the link to fill out the form.

Just register on the admission portal and during registration you will get an option for the entrance based course. Just register there. There is no separate form for DU CIC.

Can I mail prescription drugs through USPS?

The full answer takes up quite a bit of space. It depends who is mailing it and who is receiving it. Click on the link here: 453 Controlled Substances and Drugs

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