2011_Amgen Enbrel Formulary Win - OBC Campaign Prime Therapeutics
A red asterisk (*) indicates required questions.
(Call Pre-Work- Copy of Paste from Spreadsheet). CMA ID # ?
(Call Pre-Work- Copy of Paste from Spreadsheet). Telephone Number?
(Call Pre-Work- Copy of Paste from Spreadsheet). Prescriber Name: First and Last?
Please identify the state you are calling:
District of Columbia
Is this our first attempt to contact the MDO
No (Left message for return call)
Was the office contact available to talk?
No (second attempt scheduled)
(Skip if contact is available to talk)- What is the preferred time for follow-up? Any specific day requested? "You should receive a follow-up within 2 business days"
Were you aware of the recent changes with Prime Therapeutics?
Did you receive a letter from Prime Therapeutics regarding the formulary changes?
Are you familiar with the Enbrel Support Suite of Services?
Do you currently have patients on Enbrel?
Would you like our assistance in completing the exceptions/statement of medical necessity process for your Enbrel patient enrolled in Prime Therapeutics?
Yes We will have your Single point of contact, Your Enbrel Access Specialist contact you directly
(If the MD wants a sample of the Insurance Verication/Prior Authorization Form) Did you fax it to them?
No, they don't need one.
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