This episode breaks down how PBMs conduct inventory audits, the sourcing and timing issues that trigger recoupments, and how pharmacies can prepare and push back.
|Articles|January 16, 2006
CCRx beefs up Part D response
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Community Care Rx, the Medicare Part D program created by NCPA, has updated its database to help R.Ph.s determine eligibility and process claims, including correct adjudication of co-pays and deductibles for dual eligibles. CCRx also added a special fax line, extended its help desk hours, and added 100 service reps. In addition, the Rx plan temporarily removed all rejects for prior authorization, quantity limits, and step edits and set up a special code to allow pharmacies to fill initial transition scripts for nonformulary drugs.
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