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View important 2025 plan documents and forms on this page.
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HMO-POS
Plan Overview for Peoples Health Choices 65 Greater New Orleans and Baton Rouge Area – An overview of plan benefits
Annual Notice of Changes for Peoples Health Choices 65 Greater New Orleans and Baton Rouge Area – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Choices 65 Greater New Orleans and Baton Rouge Area – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Choices 65 Greater New Orleans and Baton Rouge Area – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Choices 65 Northshore – An overview of plan benefits
Annual Notice of Changes for Peoples Health Choices 65 Northshore – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Choices 65 Northshore – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Choices 65 Northshore – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Choices 65 Southland – An overview of plan benefits
Annual Notice of Changes for Peoples Health Choices 65 Southland – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Choices 65 Southland – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Choices 65 Southland – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Choices 65 Rural Southeast – An overview of plan benefits
Annual Notice of Changes for Peoples Health Choices 65 Rural Southeast – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Choices 65 Rural Southeast – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Choices 65 Rural Southeast – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) – An overview of plan benefits
Annual Notice of Changes for Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS) – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Choices Gold – An overview of plan benefits
Annual Notice of Changes for Peoples Health Choices Gold – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Choices Gold – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Choices Gold – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Medicare Advantage Patriot No Rx LA – An overview of plan benefits
Evidence of Coverage for Peoples Health Medicare Advantage Patriot No Rx LA – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Medicare Advantage Patriot No Rx LA – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Group Medicare – An overview of plan benefits
Annual Notice of Changes for Peoples Health Group Medicare – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Group Medicare – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Group Medicare – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB) – An overview of plan benefits
Annual Notice of Changes for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB) – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB) – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Group Medicare (HMO-POS) Office of Group Benefits (OGB) – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
HMO-POS C-SNP
Plan Overview for Peoples Health Complete Care LA-5 – An overview of plan benefits
Evidence of Coverage for Peoples Health Complete Care LA-5 – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Complete Care LA-5 – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Complete Care LA-6 – An overview of plan benefits
Evidence of Coverage for Peoples Health Complete Care LA-6 – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Complete Care LA-6 – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Complete Care LA-7 – An overview of plan benefits
Evidence of Coverage for Peoples Health Complete Care LA-7 – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Complete Care LA-7 – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
HMO-POS D-SNP
Plan Overview for Peoples Health Secure Complete – An overview of plan benefits
Annual Notice of Changes for Peoples Health Secure Complete – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Secure Complete – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Secure Complete – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Dual Complete LA-S5 – An overview of plan benefits
Evidence of Coverage for Peoples Health Dual Complete LA-S5 – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Dual Complete LA-S5 – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Secure Health – An overview of plan benefits
Annual Notice of Changes for Peoples Health Secure Health – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Secure Health – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Secure Health – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
PPO
Plan Overview for Peoples Health Choices – An overview of plan benefits
Annual Notice of Changes for Peoples Health Choices – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Choices – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Choices – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
Plan Overview for Peoples Health Patriot – An overview of plan benefits
Annual Notice of Changes for Peoples Health Patriot – A summary of plan benefit changes compared to the previous year and other important plan details
Evidence of Coverage for Peoples Health Patriot – Information about plan benefits, membership, covered and noncovered services, member rights and responsibilities, and other important plan details
Summary of Benefits for Peoples Health Patriot – A general summary of plan benefits
Vendor Information – A listing of providers offering benefit-related services
If you’re looking for other resources not listed below, visit the UnitedHealthcare provider website.
Other Important Documents, Links and Forms | 2025
Prior Authorization Criteria – Detailed criteria for select covered drugs
(Last updated: 8-1-25)
Step Therapy Criteria – Detailed criteria for select covered drugs
(Last updated: 8-1-25)
2025 Comprehensive Formulary for Dual Complete LA-S5, Secure Health and Secure Complete (HMO-POS D-SNP) (Last updated: September 2025)
2025 Comprehensive Formulary for Choices 65 (HMO-POS), Choices Gold (HMO-POS), Choices (PPO), Medicare Advantage Giveback LA-4 (HMO-POS) (Last updated: September 2025)
2025 Comprehensive Formulary for Complete Care LA-5 (HMO-POS C-SNP), Complete Care LA-6 (HMO-POS C-SNP), Complete Care LA-7 (HMO-POS C-SNP) (Last updated: September 2025)
2025 Comprehensive Formulary for Peoples Health Group Medicare (HMO-POS) (Last updated: September 2025)
2025 Comprehensive Formulary for Peoples Health Group Medicare for OGB (HMO-POS) (Last updated: September 2025)
(Last updated: July 10, 2025)
Peoples Health Choices 65 (HMO-POS) Greater New Orleans and Baton Rouge Area
Peoples Health Choices 65 (HMO-POS) Northshore
Peoples Health Choices 65 (HMO-POS) Southland
Peoples Health Choices 65 (HMO-POS) Rural Southeast
Peoples Health Medicare Advantage Giveback LA-4 (HMO-POS)
Peoples Health Medicare Advantage Patriot No Rx LA (HMO-POS)
Peoples Health Choices Gold (HMO-POS)
Peoples Health Complete Care LA-5 (HMO-POS C-SNP)
Peoples Health Complete Care LA-6 (HMO-POS C-SNP)
Peoples Health Complete Care LA-7 (HMO-POS C-SNP)
Peoples Health Dual Complete LA-S5 (HMO-POS D-SNP)
Peoples Health Secure Health (HMO-POS D-SNP)
Peoples Health Secure Complete (HMO-POS D-SNP)
Outpatient Chemotherapy (Cancer Guidance Program) - Training for Prior Authorization Request Submissions– shows how to submit oncology drug prior authorization requests
Specialty Guidance Program – User Guide for Authorization Request Submissions – shows how to submit specialty pharmacy prior authorization requests
Home Health Agency Update/Recertification Form – to update home health services for members, as well as to request recertification for continuation of services
Medical Necessity Form – to submit authorization requests for Peoples Health patients via fax
Outpatient Services for Peoples Health Patients: Ordering and Authorization Process
View coverage criteria here on the UnitedHealthcare website.
Peoples Health Clinical Program Resources
Optum Cancer Guidance Program FAQs
Elara Caring Healing at Home Program Overview
Advance Care Planning Coverage Guidelines
RestorixHealth In-Home Wound Care Program Overview
RestorixHealth In-Home Wound Care Patient Flyer
Complex Case Management Program
We’ve designed a personalized health profile for Peoples Health members who may be due for key health activities related to 11 quality star measures for 2025. Members who are eligible and noncompliant for at least one of the measures will be sent a health profile via mail in May. The profile:
- Contains a list of activities presented in an easy-to-read chart
- Stresses the importance of completing the activities as a contributor to overall health and well-being
- Provides dates, and in some cases results, of last-known tests or screenings when available
- Encourages members to share and discuss the health profile with their primary care provider
Here’s a sample health profile template:
Video transcript
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00:00:06,080 --> 00:00:11,040
Hello. Let me begin by introducing
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myself. I'm Dr. Brent Wallace, the chief
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00:00:11,040 --> 00:00:15,599
medical officer with People's Health.
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I'm here at our local offices in Matter,
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Louisiana. Thank you for tuning in for a
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closer look at the CMS Star measure,
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kidney health evaluation for patients
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with diabetes.
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The KED measure aims to improve kidney
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function assessment in those with
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diabetes because diabetes is the leading
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cause of chronic kidney disease. Primary
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care teams play a critical role in
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identifying and managing kidney disease.
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The measure outlines specific lab tests
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to be completed annually for a kidney
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health evaluation in patients with
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diabetes who are ages 18 to 85. The
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tests provide key information about
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kidney health including disease stage
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and risk of progression.
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Testing can be performed on the same or
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different dates of service and is
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defined by at least one EGFR annually
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and at least one urine albumin
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creatinine ratio annually which could be
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either the UACR
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or it could be a quantitative urine
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albumin test and a urine creatinine test
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performed within 4 days or less apart.
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To reiterate, the blood draw and urine
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specimen are both required within the
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current year. When an albumin test and a
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creatinine test are performed to fulfill
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the UACR requirement, the two tests must
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be completed within the 4-day time
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frame. Here are accepted codes for the
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test. Note that a ur analysis is not
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acceptable to close this care
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opportunity.
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When test results are abnormal, work
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with the patient on a treatment plan and
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document the plan and submit the
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diagnosis on the claim.
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Ensure accurate coding for all diagnoses
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and include the elements of a SOAP note
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for each.
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For a report of your People's Health
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patients due for KED testing, you can
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log in to member viewer or you can
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contact your People's Health
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representative.
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Try these supporting strategies.
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Consider a home lab test kit when
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available. To meet compliance, those
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kits must be processed by a lab or a
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provers's office. You can share the test
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result timelines with the patient as
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well and follow up with them to discuss
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the lab results and next steps. You
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should educate patients on diabetes
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management and kidney health. And
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lastly, coordinate the care with a
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specialist as needed. I want to thank
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you for the attentive care you provide
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to your people's health patients and
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your ongoing collaboration in helping us
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best support you in taking care of their
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health.
Video transcript
1
00:00:06,160 --> 00:00:11,200
Hello. Let me begin by introducing
2
00:00:08,880 --> 00:00:13,040
myself. I'm Dr. Brent Wallace, the chief
3
00:00:11,200 --> 00:00:16,320
medical officer with People's Health.
4
00:00:13,040 --> 00:00:18,080
I'm here at our local offices in Medie.
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I want to thank you for tuning in to
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learn more about helping patients adhere
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to medication regimens through long-term
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supplies and home delivery.
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Research supports that patients
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prescribed supplies of 3 months or
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longer are more likely to stick to their
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medications, leading to better health
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outcomes, and home delivery programs can
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help with timely medication refills.
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Consider prescribing 100 or 90day
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supplies for your People's Health
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patients and encourage home delivery.
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There are many benefits. A long-term
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supply offers increased convenience and
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may reduce hospitalization.
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Supplies through home delivery can
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improve medication access with 247
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pharmacist availability and that means
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better patient experience. To begin
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using these options, start by
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encouraging patients to sign up for
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Optimum Home delivery, which will
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maximize the patients plan benefits. It
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will save time and offer free shipping,
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automatic refills, and refill reminders.
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Submit request for a long-term supply
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plus three refills through Optimx or by
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phone. Optima RX is the preferred
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delivery pharmacy for People's Health
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plans, but you can use and send a
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prescription to any network pharmacy.
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For a report of your People's Health
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patients who are non-compliant for
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medication fills, you can log into
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member viewer or you can contact your
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People's Health representative.
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Patient adherence to cholesterol,
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diabetes, and hypertension medications
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is especially important. Keep in mind
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when calling in or sending prescriptions
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electronically, you should update to a
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longer supply plus three refills. When
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changing from a shorter supply, rewrite
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the prescription so the patient can
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access the longer supply immediately.
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and be sure to avoid old prescriptions
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to change dose or frequency.
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Some other strategies include scheduling
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a follow-up appointment to monitor for
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side effects and ensuring the patients
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understand how the medication works and
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emphasizing timely refills.
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Thank you for taking the time to watch
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this video and explore ways to ensure
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better medication adherence. We value
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the attentive care you provide your
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people's health patients and your
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ongoing collaboration in helping us best
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support you in taking care of their
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health.
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