Please review the attached communication regarding EnvisionRxOptions becoming the new claims processor for FetchMyMeds effective 11/1/2017.  

On August 18, 2017, the Centers for Medicare and Medicaid (CMS) issued a memo titled, "Sensipar® (cinacalcet) Furnished for the Treatment of ESRD Moving from Part D to ESRD PPS, Effective January 1, 2018."

For the Anthem HealthKeepers Plus plan, HealthKeepers, Inc. currently uses passive alerts for DUR therapy duplication edits.

Effective 11/1/2017, a new program named OrchestraRx01 Program will be processing through DST Pharmacy Solutions.

Prescription claims need to be submitted to member’s Primary insurance and then Health Alliance Medical Plan as Secondary with Other Coverage Code (OCC) 8 – claim is billing for a copay with OPR fields submitted. Once the claim has been submitted as Secondary, the member’s copay will be zero ($0).