 |
|
|
2011_OBC Campaign - EMDS Formulary Win
Please obtain the following information from your customer conversations.
|
|
|
- (Pre - Call work- Copy and paste) RECORD ID #?*
|
- (Pre - Call work- Copy and paste) Telephone Number*
|
- (Pre Call Work) Please identify the role from the Cigna OBC list*
|
- (Pre - Call work- Copy and paste) Contact Name from Cigna OBC List (please include title)*
|
- (Pre Call Work - Optional) Please type the Primary Affiliated Account (if there is Affilated Account identified from Cigna OBC list)
|
- (Pre - Call work- Copy and paste) Address from Cigna OBC List*
|
- (Pre - Call work- Copy and paste) City from Cigna OBC List*
|
- (Pre - Call work) Please identify the state you are calling*
|
- (Pre Call Work) Please identify the Zip Code*
|
- Is this our first attempt to contact the HCP office?*
|
- (Call Attempt) Was your contact attempt successful (you were able to contact a human being?)*
|
- What is the business hours of the office? (Optional)
|
- Hi, I’m ________________ calling from Connections for Growth, a patient support program, regarding Saizen’s new status as a preferred formulary product for Cigna patients.
May I speak to your Growth Hormone Coordinator? (Who in the office coordinates growth hormone treatment for patients/or deals with Insurance for Growth Hormone patients?)
Who is the Growth Hormone Coordinator? What is their role at the office?
*
|
- Was the Growth Hormone Coordinator available to talk?*
|
- (Skip if Growth Hormone is available to talk) You can select more than one choice
Would you mind if I have your dedicated Case Manager call you office at a more convenient time, or would you like a Key Account Manager to make an office visit?
Which is the best way to follow up with you?
Would you prefer email or phone call to schedule a time that is convenient to you?
If you have any questions about Saizen®, you may call us at Connections for Growth at 1-800-582-7989.
|
- (Skip if Growth Hormone is available to talk) What is the prefer time for follow up? Any specific day requested?
You should receive a followup within 2 business days.
|
- (Introduction to Growth Hormone Coordinator)
Hi, I’m ________________ calling from Connections for Growth (CFG), a Saizen® comprehensive patient support program. I understand that you are the person responsible for coordinating Growth Hormone for patients for your office?
I’m calling to advise you that three of the top 5 biggest plans in the country (United, Aetna and CIGNA) have chosen Saizen® as one of their preferred products. The formulary information is accurate as of January 1st, 2011, and will be updated periodically.
Were you aware of the recent changes with Cigna?
|
- Did you receive a letter from Cigna about the formulary changes occurring on your growth hormone patients?
|
- Are you familiar with Connections for Growth patient support program for Saizen?
|
- Do you have patients currently on Saizen?
|
- (Skip if the office is familiar with CFG)
Since you are not familiar with Saizen, I would like to explain the value the Saizen comprehensive patient support team, Connections for Growth, brings to your office.
The team at Connections for Growth is ready to support all NEW and Conversion Saizen® patients with:
•Class-leading interim drug program that lasts throughout the authorization process
•Patient assistance program that assists eligible patients with financial barriers to treatment
•One-on-one patient device training in the home or at your office
•An individually assigned case manager for every patient to coordinate their reimbursement process
•Appeal Assistance Specialists
•24/7 Tele health nurse support
Our team at Connections for Growth is available to support patients through their growth hormone conversion process by offering the following services:
•Saizen® easy Savings Program, This program may save your eligible patients up to $125.00 per month on their co-pay or coinsurance costs for 12 months if they are eligible. This can mean a savings on up to $1,500 depending on their co-payment.
•Saizen® has several different free delivery devices including easypod, an electronic, automated device that tracks injection history.
•In addition, we offer a needle free device - Coolclick2™, a pen – oneclick®, along with needle and syringe.
•To learn more about Saizen® and our devices you can visit our web site at www.saizenus.com for an interactive demonstration, or we can provide an information package.
Would you like additional information on CFG with your dedicated Case Manager‘s contact information (Teaching Tool)?
(You should receive the Fed ex package within 2 business days)
|
- Does Growth Hormone Coordinator want a follow up referral? (You may select more than one response)
|
- (Optional) Please provide details about the reason for the KAM office visit
|
- (Optional) Please provide details about the reason for the request for the Case Manager Follow Up?
|
- (Optional) Please provide details about the reason for the request for the Nurse Follow up?
|
- (Optional) What is the preferred contact method to setup appointment for KAM to visit office or Followup?
|
- What is the best number to contact the Growth Hormone Coordinator? (Please include extension; if appropriate?)
|
- Notes: Please provide any useful information for KAM, CM or RN regarding the disposition/demeanor of interaction. Any opinions or comments that EMD might find useful. Please identify who you called, role, who you were transferred to, and details to your conversation.
|
- Did the HCP office request the Product Insert mailed to them? (Answer no if we are sending the Teaching tool)
|