Cigna Commercial Clients

Cigna recently decided it will not transition its commercial customers to the RxClaim processing platform. Accordingly, the 15 Cigna commercial clients currently on RxClaim will transition to Argus as of June 1, 2015.

Your pharmacy may be receiving NCPDP Reject 41 (SUBMIT BILL TO OTHER PROCESSOR OR PRIMARY PAYER) when processing online COB claims for Priority Health Medicaid and Healthy Michigan members.

If you receive this reject, please look for the online messaging, which will direct you to enter the override code "9999" to resolve the reject.

• Additional Reject Message reads: "RESUB PA TYPE & PA 9999 IF NO OTHER COVERAGE."

The latest edition of US Script’s Pharmacy Provider Manual, effective May 1, 2015 is now available on US Script’s website. Download a copy of the updated Provider Manual from the US Script website at:

https://www.usscript.com/Media/Default/docs/US%20SCRIPT_Pharmacy%%20Manual_Update_FINAL_20150225.pdf

All vaccines and immunizations established by the Advisory Committee on Immunization Practices for patients 18 years and older, and influenza vaccines for individuals 10 years and older, can be administered at qualified retail pharmacies. 

Pursuant to state MAC regulations, please consider this to be notification that Tmesys has published a new MAC pricing list.