Member and Provider Call Center for Pharmacy Services Sample Clauses

Member and Provider Call Center for Pharmacy Services. 3.5.10.1.1 The Contractor shall have a call center with a specific toll-free telephone line dedicated to pharmacy and prescription issues to, among other things: 3.5.10.1.1. 1Respond to member questions, concerns, inquiries, and complaints related to pharmacy and prescription issues; and 3.5.10.1.1. 2Respond to provider questions, concerns, inquiries, and complaints related to among other things prescription prior authorizations and member Copayments. 3.5.10.1.2 The pharmacy services call center may be operated in the same call center as described in Section 3.14.2 of this Contract. 3.5.10.1.3 The Contractor shall develop pharmacy services call center policies and procedures that address staffing, training, hours of operation, access and response standards, transfers/referrals, including referrals from all sources, monitoring of calls via recording or other means, translation/interpretation and compliance with standards. 3.5.10.1.4 The pharmacy services call center shall have the capacity for the State or its authorized representative to monitor calls remotely. 3.5.10.1.5 The pharmacy services call center shall be equipped to handle calls from Limited English Proficiency (LEP) callers as well as calls from members who are hearing impaired. 3.5.10.1.6 The Contractor shall ensure that the pharmacy services call center is staffed adequately to respond to caller’s questions, at a minimum, from 8 a.m. to 7 p.m. eastern time, Monday through Friday, except State of Delaware holidays. 3.5.10.1.7 The Contractor shall ensure that pharmacy services call center staff shall receive ongoing training, at least quarterly, through instructor- led trainings and staff meetings. The pharmacy services information line staff must receive training immediately following changes to the pharmacy benefit or prior authorization requirements. All training materials must be provided to the State. 3.5.10.1.8 The Contractor shall measure and monitor the accuracy of responses provided by pharmacy services call center staff and take corrective action as necessary to ensure the accuracy of responses by staff. 3.5.10.1.9 The Contractor shall have an automated system available during non- business hours, including weekends and State of Delaware holidays. This automated system shall provide callers with operating instructions on what to do in case of an emergency and shall include, at a minimum, a voice mailbox for callers to leave messages. The Contractor shall ensure that the voice mailbox h...
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