Dear Pharmacy Provider; Effective February 1, 2016, Jackson Hospital will begin utilizing American Health Care’s Pharmacy Network. In preparation for this change, we ask that you please ensure that the following BIN/PCN/Group information is setup in your pharmacy claims adjudication system before February 1, 2016. This will ensure a seamless transition for the hospital membership. As always please refer to the member’s ID card for specific details. Below is a sample copy of the Jackson Hospital ID Card. BIN # 018240 PCN # AH3C GROUP # 5529

Dear Valued Provider, Please disregard any previous communication that was sent stating Prime Therapeutics (Prime) will no longer process claims for Arkansas BlueCross and BlueShield (ABCBS) Medi- Pak Advantage Part B. Prime will continue processing Part B claims until further notice. Action Required Participating Pharmacies should add or reactivate the BIN and PCN below in their system to allow claims processing for ABCBS Medi-Pak Advantage Part B Covered Persons.

Right Opt

RXBIN: 004336

RXPCN: ADV

RXGRP: RX0100, RX0101, RX0103, RX0104, RX0108, RX0118, RX4120, RX5160, RX5199

Member ID: 9 digits

Person Code:2 digits (01=Cardholder, 02=Spouse, 03-99=Dependents)

Right Opt is an existing plan sponsor with CVS/caremark consisting of various employer plans using the private health insurance marketplace. For the Rx Groups listed above Person Code is required. Please ensure you are submitting the appropriate Person Code with the Date of Birth for each dependent. Claims submitted with an incorrect Person Code may reject with the following or similar messages: