Mail Order. Matches retail
Mail Order. 1. Contractor shall be properly licensed, certified or credentialed to operate in the applicable states where dispensing mail order facilities and specialty operations reside.
2. Contractor shall maintain a mail order program for the Term of the Contract.
3. Upon receipt of a complete and fully accurate shipping address, Contractor’s subcontracted mail order facility shall be financially responsible and Contractor shall not charge the County or the Participant for drug and reshipping costs where the shipment of the medication is to the wrong address or patient, is improperly packaged, or shipped by the wrong carrier.
4. Contractor shall agree to transfer mail order prescriptions to a retail pharmacy in the case of emergency, vacation refills or if multiple prescriptions are requested and one is out-of-stock.
5. Contractor will not charge the County or members for expedited delivery if its organization causes the prescription delay. Contractor agrees to offer any member experiencing a delay in the delivery of its order the option of filling their prescription at a participating retail pharmacy.
6. Contractor will be required to collect copayments for mail and specialty services with no balance billing to the County of unpaid copayments allowed.
Mail Order. You are responsible for paying the lower of: • The applicable Cost-Sharing; or • The Prescription Drug Cost for the Prescription Drug. (Your Cost-Sharing will never exceed the Usual and Customary Charge of the Prescription Drug.) To maximize Your benefit, ask Your Provider to write Your Prescription Order or Refill for a 90- day supply, with Refills when appropriate (not a 30-day supply with three (3) Refills). You will be charged the mail order Cost-Sharing for any Prescription Orders or Refills sent to the mail order Pharmacy regardless of the number of days supply written on the Prescription Order or Refill. Prescription Drugs purchased through mail order will be delivered directly to Your home or office. We will provide benefits that apply to drugs dispensed by a mail order Pharmacy to drugs that are purchased from a retail Pharmacy when that retail Pharmacy has a participation agreement with Us or Our vendor in which it agrees to be bound by the same terms and conditions as a Network mail order Pharmacy. You or Your Provider may obtain a copy of the list of Prescription Drugs available through mail order by visiting Our website at xxx.xxxxxxx.xxx or by calling the number on Your ID card.
Mail Order. You may not solicit or accept Card Not Present transactions, including email, internet, or telephone orders (also known as “MOTO”) without prior written consent from Processor. Card Not Present and MOTO orders completed without prior written consent of Processor constitute a breach of this Agreement and may result, in the sole discretion of Processor and/or Bank, in the immediate termination for cause of this Agreement, in addition to any other remedies available under the Operating Regulations, Laws and Rules. You may be required to use an address verification service (“AVS”) on Card Not Present and MOTO transactions. AVS is not a guarantee of payment and the use of AVS will not waive any provision of this Agreement, validate a fraudulent transaction, or otherwise relieve You in any way from any claim, cause of action or injury arising out of or relating to a Card Not Present or MOTO transaction. You will obtain the expiration date and CVV2 number of the Card for a Card Not Present or MOTO transaction and submit the expiration date when obtaining authorization of the Card transaction. For Card Not Present and MOTO transactions, You will type or legibly print or electronically enter on the signature line of the Sales Draft the following applicable words or letters: “telephone order” or “TO” or “mail order” or “MO.” No Sales Draft shall be submitted for processing prior to the shipping of the product or the provision of the services purchased by the Cardholder. You acknowledge and agree that MOTO and other Card Not Present transactions have a substantially higher risk of Chargeback. You agree to be solely responsible for any claims, causes of action, liabilities or damages arising out of or relating to a MOTO transaction or other Card Not Present transaction.
Mail Order. Drug Program
1. When a prescription for long-term or maintenance medications lasting over thirty (30) days is necessary, the mail order prescription program must be used. From July 1, 2003 through June 30, 2004, the following co-pays for mail order prescriptions of ninety (90) days shall apply. For a generic drug the co-pay is $14.00. For a formulary brand name drug the co-pay is $30. For a non-formulary brand name drug the co-pay is $60. Where a generic equivalent is available the co-pay for a non-formulary brand name drug shall be $60 and the difference in cost between the generic equivalent and the non-formulary brand name drug. From July 1, 2004, the following co-pays for mail order prescriptions of ninety (90) days shall apply. For a generic drug the co-pay is $25. For a formulary brand name drug the co-pay is $50. For a non-formulary brand name drug the co-pay is $100. Where a generic equivalent is available the co-pay for a non-formulary brand name drug shall be $100 and the difference in cost between the generic equivalent and the non-formulary brand name drug. An employee must pay the full price for a prescription when the employee chooses not to use the mail order program as appropriate.
Mail Order. You may not solicit or accept Card Not Present transactions, including email, internet, or telephone orders (also known as “MOTO”) without prior written consent from Processor. Card Not Present and MOTO orders completed without prior written consent of Processor constitute a breach of this Agreement and may result, in the sole discretion of Processor and/or Bank, in the immediate termination for cause of this Agreement, in addition to any other remedies available under the Operating Regulations, Laws and Rules. You may be required to use an address verification service (“AVS”) on Card Not Present and MOTO transactions. AVS is not a guarantee of payment and the use of AVS will not waive any provision of this Agreement, validate a fraudulent transaction, or otherwise relieve You in any way from any claim, cause of action or injury arising out of or relating to a Card Not Present or MOTO transaction. You will obtain the expiration date and CVV2 number of the Card for a Card Not Present or MOTO transaction and submit the expiration date when obtaining authorization of the Card transaction. No Sales Draft shall be submitted for processing prior to the shipping of the product or the provision of the services purchased by the Cardholder without prior approval. You acknowledge and agree that MOTO and other Card Not Present transactions have a substantially higher risk of Chargeback. You agree to be solely responsible for any claims, causes of action, liabilities or damages arising out of
Mail Order. Contractor shall be properly licensed, certified or credentialed to operate in the applicable states where dispensing mail order facilities and specialty operations reside. Contractor shall maintain a mail order program for the life of the contract. Upon receipt of a complete and fully accurate shipping address, Contractor’s subcontracted mail order facility shall be financially responsible and Contractor shall not charge the County or the Participant for drug and reshipping costs where the shipment of the medication is to the wrong address or patient, is improperly packaged, or shipped by the wrong carrier. Contractor shall agree to transfer mail order prescriptions to a retail pharmacy in the case of emergency, vacation refills or if multiple prescriptions are requested and one is out-of-stock.
Mail Order. Additional inventory procedures (note that Columbus will begin its count on Monday, May 7; Lake Success and Burbank will begin their counts on Saturday, May 5):
Mail Order. Turnaround Time ‒ Intervention Required PBM shall dispense and ship from its PBM Mail Order Pharmacies 100.00% of all non-clean (requiring intervention or clarification) prescriptions for covered drugs to members within an average of 4 business days from (and including) the date of the PBM Mail Order Pharmacy’s receipt of the prescription. Quarterly 9.09
Mail Order. Turnaround Time ‒ No Intervention Required PBM shall dispense and ship from its PBM Mail Order Pharmacies 100.00% of all clean (not requiring intervention or clarification) prescriptions for covered drugs to members within an average of 1 business day from (and including) the date of the PBM Mail Order Pharmacy’s receipt of the prescription. Quarterly 9.09% Member Services: Call Blockage PBM will have a call blockage rate of no greater than 0.00%. Carrier will have a call blockage rate of no greater than 1.00%; provided that in no case shall PBM instruct or permit carrier to block calls. Quarterly 9.09% Member Services: Phone Abandonment Rate PBM guarantees calls to Member Services toll-free phone lines shall have an abandonment rate of 2.00% or less. Quarterly 9.09
