About APCI

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(800) 532-2724

Since 1984, APCI has been the ‘united voice of independent pharmacy’

APCI began as a small buying group for a limited number of independent pharmacies in central Alabama. Since that time, the cooperative has grown to more than 1,800 members pharmacies in 26 states, and provides its members with a wide range of products and services.

Our mission is to represent the economic and professional interests of independent pharmacies by providing leadership, vision, and a collective voice for our members in the healthcare marketplace. Our goal is to level the playing field for our member pharmacies by providing innovative, targeted programs to benefit our entire membership.

1

Dec

2015

CVS/caremark: New Implementation for Case New Holland Industrial

Effective: January 1, 2016

Case New Holland Industrial

Effective January 1, 2016, CVS/caremark will begin to administer the prescription benefits for Case New Holland Industrial. Please update or create plan member profiles to reflect the changes regarding the following new plan adjudicating through CVS/caremark.

RXBIN: 004336

RXPCN: ADV

RXGRP: RX1596

Member ID Format: 9 digits

Person Code : 2 digits

1

Dec

2015

CVS/caremark: Aetna Consumer Business- Southeastern PA

Effective: January 1, 2016

Aetna Consumer Business Southeastern PA

RXBIN: 610502

RXPCN: AETCRXC

Member ID format: 12 bytes numeric

Effective January 1, 2016, Aetna will introduce new Individual, nonMedicare plans

called Aetna LeapSM .

Pharmacy network is smaller for new plans

The new network doesn’t include all pharmacies. It’s a smaller network of pharmacies.

As a participating pharmacy in this network, you can provide pharmacy services for

members in these plans. Please help our members with transferring prescriptions from

a nonparticipating pharmacy, if they ask. And, just use your standard guidelines.

1

Dec

2015

Prime Therapeutics: Blue Cross Blue Shield of Illinois Covered Persons Interchangeable Biological Product

Effective: January 1, 2016

Dear Valued Provider,

Effective January 1, 2016, in accordance with Illinois Senate Bill 455, Participating Pharmacies may

substitute an interchangeable biological product for a prescribed biological product if the substituted

product has been determined by the United States Food and Drug Administration (FDA) to be

interchangeable, and the Prescribing Provider does not designate orally, in writing, or electronically that

substitution is prohibited. Participating Pharmacy must inform the Covered Person of the substitution.

1

Dec

2015

US Script: Peach State Health Plan Import Notice Regarding Third Party Liability Updates

Effective: November 17, 2015

Please direct any questions to the US Script Help Desk at: (800) 460-8988

ATTENTION PHARMACISTS:

Important Notice Regarding Third Party Liability Updates

Important Information Effective 11/17/2015: If a Peach State Health Plan member has primary insurance coverage other than Peach State Health Plan, you will receive a transaction reject message when attempting to enter a prescription claim to US Script as primary.

The transaction reject message will show the member’s current primary insurance processing information along with a point-of-sale message of reject code: 41 - SUBMIT BILL TO OTHER PROCESSOR OR PRIMARY PAYOR. For specialty medications, the claim will be allowed to process as long as the primary has already paid. Other coverage codes 2, 4 and 8 are allowed for non-primary claims to process in the event the TPL has already paid.

Please use the following process for members who no longer have primary insurance:

Pharmacy tech or pharmacist will need to call the US Script Pharmacy Help Desk to confirm rejection from primary payer information on file. Approval will be requested and a call will be returned within 24 hours with a decision.

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