CVS/caremark: RXPCN Required WellCare Health Plans

Author: Kerri Williams/Friday, January 29, 2016/Categories: APCI Choice

As previously communicated, effective January 1, 2016, CVS/caremark began to administer the prescription benefits for WellCare Health Plans. Beginning January 28, 2016, claims submitted with an incorrect RXPCN will reject with the following or similar message: Reject 85 : <Claim Not Processed> <Submit RxPCN MCAIDADV> To minimize disruption, please update member profiles with this RXPCN. RXBIN: 004336 RXPCN: MCAIDADV RXGRP: Varies by plan/state. Use the information printed on the member’s ID card or see table below. Note : Pharmacy network participation varies by plan and region. Your pharmacy may not participate in all plans for WellCare.

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