On Friday, January 22nd, Change Healthcare made a difficult decision to ‘pause’ the migration of the SelectRx claims adjudication application due to circumstances beyond our control. Over the last few days, we have taken steps to address and mitigate what was beyond our control and reschedule the migration of SelectRx for the weekend of February 5, 2016.   That being said, the system will be unavailable Friday, February 5th  beginning at 11:50 pm EASTERN and is anticipated to be returned online late morning on Saturday, February 6th.   During this time, pharmacy will receive the following rejection response from Change Healthcare’s switch.             ERX03: Connection to Payer Down     For your convenience I’ve attached a list of BINS that will be impacted during our down time.   We appreciate your patience!

Effective 2/1/2016 Effective February 1, 2016 Cigna-HealthSpring is changing the disposition of the Duplicate Therapy Alert (DUPTHER) for the therapeutic class Oral Antipsychotics. Duplicate Therapy identifies when a member takes two or more prescriptions that provide the same therapeutic effect. The new alert status for Duplicate Therapy will be set to reject (DUR Reject 88) at POS (point-of -service) and require pharmacies to review and override the rejected claim using the appropriate DUR/PPS Clarification Codes.

As previously communicated, effective January 1, 2016, CVS/caremark began to administer the prescription benefits for WellCare Health Plans. Beginning January 28, 2016, claims submitted with an incorrect RXPCN will reject with the following or similar message: Reject 85 : <Claim Not Processed> <Submit RxPCN MCAIDADV> To minimize disruption, please update member profiles with this RXPCN. RXBIN: 004336 RXPCN: MCAIDADV RXGRP: Varies by plan/state. Use the information printed on the member’s ID card or see table below. Note : Pharmacy network participation varies by plan and region. Your pharmacy may not participate in all plans for WellCare.

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