Drug-Disease Contraindication and Drug Allergy DUR (drug utilization review) are pharmacy level responsibilities.

Effective January 1, 2018, Prime Therapeutics (Prime) will continue processing commercial claims for Covered Persons of Adient and Yanfeng, employer groups of BlueCross BlueShield of Illinois.

Beginning December 18, 2017 CalOptima’s Medi-Cal Line of Business will require the use of the Patient Residence Code, which is found in field 384-4X of the Commercial NCPDP Payer Sheet, to be listed on ALL CalOptima Medi-Cal claims.

By providing a prescription discount card or coupon, members can be sure that they receive the best prescription prices at pharmacies that are convenient to them.

Effective January 1, 2018, OptumRx will be enabling an enhanced prescriber DEA license scope of practice check at point of sale for all Schedule II-V controlled medication claims to prevent payment of scheduled medication claims from unauthorized prescribers.