APNS Pharmacies have now been fully integrated!

As of today, APNS pharmacies have been fully integrated back into the OptumRx Limited Value Network and are able to process and/or reprocess claims back to the effective date of 7/1/2016.

Effective 09/15/2016, for UnitedHealthcare Community Plan of Mississippi members, you must review medications flagged with the reason code TD (Therapeutic Duplication) to resolve any duplication in the pharmacy system before dispensing the medication. TD is a safety edit that compares the member’s current medications to the drug you are processing. This reason code alerts you when a there is a request to fill a member’s medication within the same class as a medication already filled within the last 30 days so you can research why the patient is attempting to fill another medication in the same class so quickly. When the pharmacy system flags a medication for TD, it produces a soft reject and will display the message: TD: ANOTHER [specific drug class] PRODUCT WAS FILLED.

Florida Medicaid Molina Healthcare of Florida . RXBIN: 004336 RXPCN: ADV RXGRP: RX0794 Due to the rural nature of the community, Molina Healthcare will NOT implement the recently communicated pharmacy network changes to be effective November 1, 2016, in Region 1. We appreciate your continued dedication in servicing our members and look forward to a strong partnership in the health of our members. If you have any questions or concerns, please contact Lisssette Martinez at Molina Healthcare of Florida at: (866) 422-2541 ext. 223515.

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