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  3. Program Guidelines & Eligibility Workflows

Program Guidelines & Eligibility Workflows

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Focus: The "Rules" of the programs, clinical criteria, discharges, and specific client setups.

  • Mental Health (MH) Prescribing: Overview
  • Cardiometabolic (CMB) Prescribing: Overview
  • Self Pay GLP1 or COM with Formulary Customizations: Agent Guide
  • Operational Guide: GLP-1 Eligibility, Workflows & Escalations
  • Member Discharged from Prescribing: External Prescriber Override
  • Behavior Change Pathway and Medication Re-evaluation
  • GLP-1 Use Case Overview

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