Creating Formulary Information For an Account

This task explains how to create formulary information for an account.

To create formulary information for an account

1. Navigate to the Plan Formulary view.

   For information on how to navigate to the Plan Formulary view, see Creating Health Plan Information For an Account.

2. In the Plan Design list, select a health plan.

3. In the Formularies list, create a new record and complete the necessary fields.

   Some fields are described in the following table.

   Field	Comment
   Type	See About Managed Care in Siebel Life Sciences for definitions of the default values in this LOV.
   Market	The option selected in this field determines which products are available in the formulary’s Products list.

4. In the Products list, create a new record and complete the necessary fields.

   Some fields are described in the following table.

   Field	Comment
   Status	Off Formulary — Banned from the formulary. On Formulary — Approved by the formulary. On/Prior Auth — Physicians require MCO or PBM approval before prescribing. On/Restricted — One of the few drugs allowed its therapeutic class. On/Exclusive — The only drug allowed in its therapeutic class.
   Tier	If the product is in a tiered formulary, indicate the tier.
   Reimbursable	For example, if a product is off formulary, but can be reimbursed with prior authorization, select this check box.
   Qty Limit	The quantity allowed for a patient each year.
   Competitor	This field is filled in automatically when the product’s type is Competitive Product.

   By adding a product to the Products list you indicate it is on formulary and can track its status.

   Note: You cannot edit the Competitor field. A check mark appears in this field if the product you selected for the Name field is a competitor’s product. For more information, see Specifying a Competitor.

5. Repeat Step 3 and Step 4 until you have created a record for every product on the formulary.