2011_GNE Access to Care Foundation CSR Survey - v2

This is NOT an assessment/test. This is a survey to assess the needs on the floor. We are putting together some small classes for the GATCF team and would like to make sure and address all your questions during this time. Your honesty will contribute to the success of this training.
Name (optional): 


A red asterisk (*) indicates required questions.

  1. Ranking: 1-Understand Process (When you think you are doing the process correctly, no doubts), 2-Need Clarification (if you are not sure that you are doing it correctly) N/A is if you do not perform that process.

    Do you know how to:*

            1 2       N/A
      process a refill requested by phone? Understand the Process Need Clarification  
      process a refill requested by fax? Understand the Process Need Clarification  
      create eligibility? Understand the Process Need Clarification  
      identify a grandfathered patient? Understand the Process Need Clarification  
      work reports given to me (Re-enrollment, refills incompletes etc.)? Understand the Process Need Clarification  
      answer inbound calls? Understand the Process Need Clarification  
      triage/transfer a phone call? Understand the Process Need Clarification  
      explain and refer to co-pay cards and INO's? Understand the Process Need Clarification  
      manage the failed faxes? Understand the Process Need Clarification  
      search for duplicate reimbursement cases? Understand the Process Need Clarification  
      attach an image to an existing reimbursement case? Understand the Process Need Clarification  
      attach an image to PAP? Understand the Process Need Clarification  


  1. (Optional) Use this section to explain or comment on any areas above that you needed clarification.


  1. Ranking: 1-Understand Process (When you think you are doing the process correctly, no doubts), 2-Need Clarification (if you are not sure that you are doing it correctly) N/A is if you do not perform that process.

    Do you know when to:*

            1 2       N/A
      create a Reimbursement case? Understand the Process Need Clarification  
      use scripting for reimbursement case? Understand the Process Need Clarification  
      leave a reimbursement case at intake service? Understand the Process Need Clarification  
      start a new case verses just attaching a document? Understand the Process Need Clarification  
      attach an image to an existing reimbursement case? Understand the Process Need Clarification  
      attach an image to a PAP file? Understand the Process Need Clarification  
      note both reimbursement and PAP cases? Understand the Process Need Clarification  


  1. (Optional) Use this section to explain or comment on any areas above that you needed clarification.


  1. Rank the following: 1- BI, 2 - BI+PAP and 3- Prescreen or just attach to existing PAP case

    You are doing the intake on the SMN, what type of case or action would you take if:*

          1 2 3     N/A
      Service marked is BI/Prior Authorization   
      Service marked is Co-pay Assistance   
      Service marked is GATCF Patient Assistance (Insurance is attached)   
      Service marked is GATCF Patient Assistance (NO Insurance attached)   
      Services marked are BI/Prior Authorization and GATCF Patient Assistance (Insurance is attached)   
      Services marked are BI/Prior Authorization and GATCF Patient Assistance (NO Insurance attached)   


  1. (Optional) Use this section to explain or comment on any areas above that you needed clarification.


  1. Rank is as follows: 1- Reimbursement, 2 - GATCF/PAP, 3-Not sure

    Choose who would do the following process:*

          1 2 3    
      Who views and starts the intake of the SMN?   
      Who sends the first fax to the Physician explaining if we are missing anything or if we have everything needed?   
      Who follows up on the misisng information for a reimbursement case?   
      Who follows up on the missing information for the PAP file?   
      Who finishes the reimbursement case after all information has been received?   
      Who denies a PT for PAP if drug coverage exists and patient is new to PAP?   
      Who denies a PT for PAP if drug coverage exists and patient is an existing PAP patient?   
      The reimbursement case is complete and coverage does not exist. Who follows up on the missing information for the GATCF part of this case?   
      Who processes refills (phone/fax)?   


  1. (Optional) Use this section to explain or comment on any areas above that you needed clarification.


  1. List THREE processes you would like covered in training.*





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