10

Jan

2017

Express Scripts: Changes to Amerigroup* Refill Too Soon limits effective Dec. 27, 2016

Effective: 12/27/2016 Texas BIN: 003858 PCN: MA RxGroup: WKEA

Effective Dec. 27, 2016, Amerigroup changed its “Refills Allowed After” (i.e. Refill Too Soon) limits for members enrolled in its Medicaid and CHIP plans.  
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10

Jan

2017

Express Scripts: Changes to BlueChoice HealthPlan Refill Too Soon limits effective Dec. 27, 2016

Effective: 12/27/2016 South Carolina BIN: 003858 PCN: A4 RxGroup: WFSA

Effective Dec. 27, 2016, BlueChoice HealthPlan changed its “Refills Allowed After” (i.e. Refill Too Soon) limits for members enrolled in its Medicaid plans.  
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23

Nov

2016

Express Scripts Update

Effective 10/01/2016, the APNS agreement with ESI renewed for the next contract cycle period.   The rates offered were far more aggressive than previous years. However, when attempting to negotiate these rates, APNS was informed there was no room for negotiation.  The contract renewal was a “take it or leave it” situation.  APNS was informed that all PSAOs would be under the same contract arrangement as each of their cycles comes up for renewal.
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6

Sep

2016

Express Scripts: Emergency Override for ‘Refill Too Soon’ in North Carolina Due to Tropical Storm

Part D and Medicare Advantage plans only  

Emergency Override for ‘Refill Too Soon’ in North Carolina Due to Tropical Storm  

The governor of North Carolina has issued a state of emergency for the following counties due to tropical storm Hermine: Beaufort, Bertie, Bladen, Brunswick, Camden, Carteret, Chowan, Columbus, Craven, Cumberland, Currituck, Dare, Duplin, Gates, Greene, Hertford, Hoke, Hyde, Jones, Lenoir, Martin, New Hanover, Onslow, Pamlico, Pasquotank, Pender, Perquimans, Pitt, Robeson, Sampson, Tyrrell, Washington and Wayne.  
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15

Aug

2016

Coordination of Benefits (COB)

Coordination of Benefits

As we are all aware, some patients have multiple insurance coverage options.  The pharmacy can be held liable for billing an incorrect insurance provider unknowingly as the primary insurance.  As a pharmacy, it is important that you ask all patients to provide you with all forms of insurance they are currently enrolled in.  Sometimes the onscreen adjudication messaging will inform the pharmacy if there is a secondary plan or if the plan you are trying to bill should be the secondary plan. 
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