OptumRx will assume responsibility for claims processing for members of Dish Network L.L.C. Please Note:  All plan participants of Dish Network L.L.C. will receive a new member identification (ID) card. Please refer to the sample of the new ID card below.  Prescriptions need to be processed on-line using the Dish Network L.L.C. ID card information.

Express Scripts administers the prescription drug benefit for Consolidated Nuclear Security LLC members. Some of these members are changing benefit groups on March 1, 2016 and will receive new ID cards with their new Rx Group. (Please note the member ID number is not changing.) However, these members may not have their new cards by the March 1 effective date. If a Nuclear Security LLC claim rejects with NCPDP Reject Code 51 (Non-Matched Group ID), please ask the member for his/her new ID card or contact the Express Scripts Pharmacy Services Help Desk at 800.922.1557.

Ohio Medicaid Molina Healthcare of Ohio As previously communicated on January 25, 2016, Molina Healthcare of Ohio is an existing plan with CVS/caremark. On March 1, 2016, a portion of Molina Healthcare of Ohio’s population is moving to a new RXGRP and will receive new cards with updated claims processing information. Please update or create plan member profiles to reflect the new RXGRP as appropriate. RXBIN: 004336 RXPCN: MCAIDOH RXGRP: RX0718 Member ID Format: 12 digits Person Code: 001

As previously communicated on September 15, 2015, and as included in the 2016 Provider Manual, certain claim transactions are now subject to the Transaction Submission Resolution Management Service Fee (TSRMSF).
Beginning January 1, 2016, CVS/caremark implemented the TSRMSF for Medicare Part D claims, and as a result, standard Transaction Fees are not being charged for these transactions. In April 2016, CVS/caremark will collect the TSRMSF as a lump sum offset to your regular pharmacy payment. The initial lump sum offset in April will cover transactions submitted between January 1, 2016 and March 31, 2016. Beginning in May 2016, and in each subsequent month, CVS/caremark will capture the transactions submitted during the previous month and collect the TSRMSF as a lump sum offset to your regular pharmacy payment.

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