Catamaran: Cigna-HealthSpring Providers - "Over-the-Limit" Transition Fills

Author: Angie Shirley/Saturday, March 14, 2015/Categories: APCI Choice

REMINDER:  Catamaran pharmacy providers have agreed to follow all federal and state requirements, to include Medicare and Medicaid rules, including accurate submissions and temporary supply rules which are mandated by many of these programs.

To that end, it is important to remember that for persons in transition, who receive a reject message for "Over-the-Limit" for their refills, that you resolve the limit issue and re-submit as timely as possible, preferably same day, but at least within a 24-hour time period. This will help ensure that members receive their medication in a timely manner, with little to no delay.

**Note - Transition fills should be submitted for no more than a 30 day supply (31 if it will be sent to a LTC pharmacy)

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