21

Dec

2016

Express Scripts: Payer Sheets

Effective January 1st 2017

Please see the attached PDF for Express Scripts Payer Sheets: commercial, the Department of Defense (DoD), Medicaid, Medicaid Subrogation, Medicare and Workers’ Compensation.

1

Dec

2016

PerformRx: Prestige Health Choice Plan

Effective December 1st 2016

As of 12:00am EST, PerformRx has begun processing Medicaid pharmacy claims for Prestige Health Choice.

The purpose of this notification is to provide you with useful information to assist you in processing these pharmacy claims successfully.

*Please see attached PDF for more information.

29

Nov

2016

Envolve Pharmacy Solutions: Superior Health Plan - Mosquito Repellent Benefit

Texas now covers mosquito repellents for the prevention of Zika virus. The following notice describes claims processing, eligibility, and benefit information specific to the mosquito repellent benefit for the below programs. The last page of this document contains a prescription template for claims processing.

Covered programs*:

  • Medicaid (Managed Care, MCO; and fee-for-service, FFS)
  • Children's Health Insurance Program (CHIP) and CHIP-Perinate
  • Children with Special Health Care Needs Services (CSHCN)
  • Healthy Texas Women (HTW)

*Mosquito repellent is not a benefit of Kidney HealthCare

*Please see attached PDF for more information.

18

Nov

2016

CVS Caremark®: US Script - Georgia Medicaid Peach State Health Plan

Effective Septemeber 1st 2016

As previously communicated by US Script and CVS Caremark®, Peach State Health Plan began using the CVS Caremark pharmacy network on May 2, 2016, while claims processing and payment remained with US Script. This notice is to inform you that effective September 1, 2016, CVS Caremark will begin to process claims for Peach State Health Plan. All claims for Peach State Health Plan will now be reimbursed according to your CVS Caremark Network Enrollment Forms and be paid according to CVS Caremark processing rules and payment cycles, which will appear on your CVS Caremark 835 or remittance advice.


*Please see attached PDF for more information.

18

Nov

2016

CVS Caremark®: Illinois Medicaid - IlliniCare Health

Effective Septemeber 1st 2016

As previously communicated by US Script and CVS Caremark®, IlliniCare Health began using the CVS Caremark pharmacy network on April 13, 2016, while claims processing and payment remained with US Script. This notice is to inform you that effective September 1, 2016, CVS Caremark will begin to process claims for IlliniCare Health. All claims for IlliniCare Health will now be reimbursed according to your CVS Caremark Network Enrollment Forms and be paid according to CVS Caremark processing rules and payment cycles, which will appear on your CVS Caremark 835 or remittance advice.


*Please see attached PDF for more information.

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