Dear Valued Provider, Due to system maintenance at Prime Therapeutics, our claims processing system will be unavailable for claims adjudication during the time frame listed below. Saturday January 16, 2016 11:00 p.m. to Sunday January 17, 2016 1:00 a.m. (Central Time) During this downtime, claims will not be processed.  Please communicate this information to your pharmacies. If you have any questions regarding processing claims, please call the Prime Contact Center at 800.821.4795. Thank you, Pharmacy Network Management Prime Therapeutics LLC Prime Therapeutics made the following annotations --------------------------------------------------------------------- CONFIDENTIALITY NOTICE: The information contained in this communication may be confidential, and is intended only for the use of the recipients named above. If the reader of this message is not the intended recipient, you are hereby notified that any dissemination, distribution, or copying of this communication, or any of its contents, is strictly prohibited. If you have received this communication in error, please return it to the sender immediately and delete the original message and any copy of it from your computer system. If you have any questions concerning this message, please contact the sender.

Please set up Bin number 018497 ASAP; the payer sheet is attached.  Please let us know should you have any questions.   Thank you   ProCare Rx Provider Relations Department

HealthPartners is experiencing some eligibility issues with a small portion of the City of Duluth/Duluth Joint Powers employees and their dependents. We hope to have this corrected very soon. If you receive a rejection stating that the member is not covered by HealthPartners, please contact HealthPartners at 1-800-492-7259 between the hours of 8:00 am and 6 pm Monday through Friday. HealthPartners can verify the member and correct the records if necessary. BIN: 003585 PCN: 24002

Per Indiana rule 405 IAC 5-24-8(a) prior authorization will be required for substitutable brand name drugs. Beginning on January 11, 2016, MDwise Medicaid (Healthy Indiana Plan and Hoosier Care Connect) prescriptions for which the prescriber has indicated "Brand Medically Necessary" will follow a new procedure for review and determination. Pharmacies will no longer be able to submit the claim with a DAW code of 6 or 9 for these prescriptions. For consideration of ‘Brand Medically Necessary’ claims, the prescriber will be required to submit a prior authorization request. Those requests will be considered within 24 hours. Prescribers should use the attached form to submit these requests, also found on the MDwise website, mdwise.org. BIN: 003585 PCN: ASPROD1 GRP: MDW