28

Aug

2015

Express Scripts: Emergency Override for ‘Refill Too Soon’

Part D and Medicare Advantage plans only

The governor of Florida has issued a State of Emergency for the entire state due Tropical Storm Erika.

 

Due to this issuance, Express Scripts has implemented Emergency Refill Too Soon procedures in the state of Florida for Part D and Medicare Advantage plans.   

 

Effective immediately, if a patient from the disaster area attempts to fill a prescription for lost or damaged medication resulting from the disaster, and the claim rejects with a NCPDP reject 79 (Refill Too Soon), the pharmacy should enter override code 91100000001 in NCPDP vD.0 field 462-EV “Prior Auth Number Submitted.” 

 

This override code should be used to process claims only for affected Part D and Medicare Advantage members in the state of Florida through September 27, 2015.

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22

Aug

2015

Prime Therapeutics: Claims Processing Outage Notification

Due to system maintenance at Prime Therapeutics, our claims processing system will be unavailable for claims adjudication during the time frame listed below:  

Saturday August 22, 2015 11:00 p.m. to Sunday August 23, 2015 3:00 a.m. (Central Time)    

During this downtime, claims will not be processed.

30

Jul

2015

Alabama Medicaid Bulletin - Major Change

July 2015

MAJOR CHANGE: Effective for check writes July 24, 2015, and thereafter, Providers’ 835 electronic remittance advices will NOT be available to providers immediately following the check write.

23

Jul

2015

Express Scripts: Network Pharmacy Weekly

Edition: July 23, 3015

15

Jul

2015

Mirixa Program Announcement: Aetna 30-90 Day Conversion Program

Effective: 7/28/2015

Mirixa is dedicated to bringing pharmacies additional opportunities to engage more patients and deliver measurable results through our Medication Therapy Management programs. On July 28th, the Aetna 30-90 Day Conversion Program will begin.   

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