Effective 02/26/2016
Dear Pharmacy Provider:
On February 26 2016, an issue has been identified for Independent Blue Cross Medicare Part D (IBCMEDD) plans regarding benefit stage qualifier fields and benefit stage amount fields being sent to the secondary payer. In this instance the secondary payer cannot coordinate benefits and pay the claim as secondary. If you experience this scenario, please do not call the secondary payer as we are working to resolve this issue.

Transition Fill

INTotal Health

RXBIN: 004336

RXPCN: ADV

RXGRP: RX4037

CVS/caremark administers the prescription claims processing for INTotal Health. Effective immediately, INTotal Health will use the Pharmacy Help Desk to approve Transition Fills for plan members in their first ninety (90) days of coverage.

Effective January 1, 2016, in accordance with the Centers for Medicare and Medicaid Services (CMS) regulations in §§ 423.501, 423.505(b)(21), and 423.505(i)(3)(viii) Part D plans are required to disclose to pharmacies MAC prices to be updated in advance of their use for reimbursement of claims. To comply with these requirements, CVS/caremark Part D Services has implemented enhancements to its Pharmacy Portal/MAC inquiry tool, located at https://rxservices.cvscaremark.com/. The following is intended to assist pharmacies when navigating within the Pharmacy Portal in order to use the Medicare Part D MAC enhancements that will be effective on January 1, 2016.

Florida Medicaid Molina Healthcare of Florida For the first thirty (30) days of newborn membership, pharmacy claims should be processed under the mother’s Member ID. After the 30-day grace period, please ask the parent/guardian to present the newborn’s new ID card for processing future claims. For any issues with processing a claim, please contact Molina Healthcare. RXBIN: 004336 RXPCN: ADV RXGRP: RX0794 Member ID Format 9 digits Person Code 2 digits