Creating Health Plan Information For an Account
This task explains how to create health plan information for an account.
To create health plan information for an account
Navigate to the Accounts screen, then the Accounts List view.
In the Accounts list, drill down on an account.
Click the Plan Formulary tab.
In the Plan Design list, create a new record and complete the necessary fields.
Some fields are described in the following table.
Field Comment Plan Type
See the table in the topic About Managed Care in Siebel Life Sciences for definitions of the default values in this LOV.
No. of Lives
Number of lives in the health plan. This number cannot exceed the total lives entered for the account.
Note: The Total Lives field must be completed in the Account form before you enter a value in this field. (Click on the show more button to see this field.)% of Total Lives
Equal to [(Number of Lives at Plan Level) divided by (Number of Lives at Account Level)] multiplied by 100.
Utilization
Number of health plan members who are using health plan benefits. This number cannot exceed the number of lives in the health plan.
Utilization %
Equal to [(Utilization) divided by (Number of lives at Plan Level)] multiplied by 100.
Co-Payment
Typically, the co-payment amount for a member visit to a primary care physician. The pharmacy co-payment is entered separately for each product.
P & T Members Name
Names of contacts who are on the Pharmacy & Therapeutics committee.
Pharmacy Distribution
Type of distribution, such as in-house, contracted, or mail-order.