Effective January 1, 2017, CVS Pharmacies will no longer participate in certain Prime networks. As a result of this processing change, your Participating Pharmacy may see an increase in Covered Person prescription claims and transfers.

The CVS Caremark® Pharmacy Performance Department is providing its Network Pharmacies with a reminder regarding your pharmacy’s contractual requirements with respect to accurate claims billing and dispensing.

CorVel Corp
As previously communicated on July 18, 2016, effective August 28, 2016, CorVel Tennessee claimants will receive new pharmacy benefit insurance cards to comply with the state adoption of the ODG Formulary. All processing information is identical, except for the new Rx Group number of RX2853. If your claimant does not present their new pharmacy card, please use Rx Group number RX2853 when processing. For all questions, please contact CorVel at 1-800-563-8438.

Appropriate Billing of Medications

Purpose of communication: The CVS Caremark® Pharmacy Audit Department is providing network pharmacies with basic information on the appropriate billing of nasal spray medications to help prevent audit discrepancies and non-compliance with the CVS Caremark Provider Manual and Centers for Medicare and Medicaid Services (CMS) requirements.