Prime has formulated a list of the most commonly misbilled medications.  Please take time to print off this list for your reference, as it is a good tool to help your pharmacy avoid some common mistakes that could lead to costly audits.

Dear Valued Provider,

Yesterday, November 15, 2016, Prime Therapeutics advised Participating Pharmacies of an eligibility issue that was affecting some Florida Blue covered persons. This issue has been resolved as of approximately 10:00AM Eastern time today. Claims should now process as expected. We apologize for any inconvenience to our Participating Pharmacies and Florida Blue Covered Persons.

Any claim rejections received by participating pharmacies can now be reprocessed.

If you have any questions regarding claims processing, please call the Prime Contact Center at 800.821.4795.

Sincerely,

Pharmacy Network Management

Prime Therapeutics LLC

OptumRx will be performing scheduled maintenance to our claim processing system on Saturday, November 19 from 9:00p.m. (PT) until 5:00 a.m. (PT) Sunday, November 20. Actual maintenance time required for this outage may be reduced, at which point OptumRx will resume processing claims and other functions earlier.

Pharmacies will be unable to process claims during the scheduled outage. The Pharmacy Help Desk will not be able to answer eligibility or benefit questions during this down time. We apologize for any inconvenience this may cause.

TO REDUCE PROCESSING ERRORS, PLEASE CONFIRM THE INFORMATION ON MEMBER’S ID CARD PRIOR TO SUBMITTING PRESCRIPTION CLAIMS.

Should you have any questions or require assistance, please contact the OptumRx Help Desk, 24 hours a day, 7 days a week:

OptumRx Help Desk phone numbers:

1-800-797-9791