Pharmacy benefit resources
STANDARD PLAN MEDICATIONS – Four tier formulary guide to drug coverage
PREVENTIVE MEDICATIONS – Medications covered by Prescryptive at no cost to members.
SPECIALTY MEDICATIONS – List Specialty Medications and information about our Specialty Patient Care Program.
PRIOR AUTHORIZATION MEDICATIONS – Medication list and information to help your patients get started.
MEDICATIONS WITH QUANTITY LIMITS – Medications that have limited quantities restrictions without a prior authorization.
AGE LIMIT RESTRICTIONS – Medications with an age limit restriction that requires a prior authorization.
HEALTHY VALUES MEDICATION LIST – Learn about medications that offer the best value.
EFT/ACH FORM – Fill out to receive payments for all claims electronically via ACH.
PAYER SPECIFICATION SHEET – Reference to consistently entering codes for claims adjudication.
PHARMACY ENROLLMENT FORM – Fill out to join our national network.
PHARMACY APPEALS AND GRIEVANCES FORM – Fill out to provide documentation for appeals and grievances.