Effective October 1, 2016, CVS Caremark® will begin to administer the prescription benefits for HCCCC-Teamsters Local 922. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS Caremark.

*Please see attached PDF for more information.

Dear Pharmacy Network Provider,

On Tuesday, October 11, 2016, Argus will implement two global claims processing edits for point of sale (POS) and batch claims.

• Claims will then reject in the following scenarios:

o If a claim is submitted using lowercase letters in any alphanumeric field, that claim will return the NCPDP Reject Code 614 (UPPER CASE REQUIRED).

o If a claim is submitted with a decimal in the Diagnosis Code field(s), that claim will return NCPDP Reject Code 39 (MISSING/INVALID DIAGNOSIS CODE).

o Both edits are non-overridable and will not have an associated Argus Error Code.

• Pharmacies must correct the claim and resubmit for processing.

3rd Edition Version 2 - Available Now
Applicable to OptumRx’s and its affiliate Catamaran’s
Participating Pharmacy Network Agreements

*Please see attached PDF for more information.

In this week's update, new legislation is introduced in the U.S. Senate to end DIR fees, Optum will meet with pharmacies and wholesalers regarding a new policy on distributor accreditation, and more!