Pharmacists have the ability to override High Dose MED soft reject DUR by using appropriate DUR/PPS Reason, Professional, and Result codes.

Dear Pharmacy Partner,

Below is an update from our prior January 6, 2017 email communication regarding changes to our Opioid Morphine Equivalent Dose (MED) program that placed edits at the point of sale. 

Dear Valued Provider,
Effective January 1, 2017, Blue Cross Community Integrated Care Plan (ICP) and Blue Cross Community Family Health Plan (FHP) Covered Persons will be subject to a Morphine Equivalent Dose (MED) quantity limit. Please see the attachments below for further processing instructions.

If you have questions regarding claims processing, please call the Prime Contact Center at 800.821.4795.

Sincerely,
Pharmacy Network Management
Prime Therapeutics LLC

Prime Therapeutics Contracting Fax number: 877.823.6373

*Please see attached PDF for more information.

Please be advised that, effective 1/1/2017, MedImpact will be implementing new POS edit functionality to support mandatory 2017 CMS requirements for Medicare Part D claims processing.

*Please see attached PDF for more information.