Examples of Benefit manager in a sentence
Safety checks – Before the Member’s prescription is filled, Our pharmacy Benefit manager or We perform quality and safety checks for usage precautions, drug duplication, and frequency of refills (e.g. refill prior to seventy-five percent (75%) day supply used).
Some pharmacies have contracted with Us or with Our pharmacy Benefit manager to accept a negotiated amount as payment in full for the covered Prescription Drugs that they dispense.
When a Member purchases covered Prescription Drugs from a pharmacy that has not contracted with Us or with Our pharmacy Benefit manager to accept a negotiated amount as payment in full for the covered Prescription Drugs that it dispenses, the Allowable Charge is the negotiated amount that Participating Pharmacies have agreed to accept for drugs dispensed.
Some pharmacies have contracted with the Claims Administrator or with the Claims Administrator's pharmacy Benefit manager to accept a negotiated amount as payment in full for the covered Prescription Drugs that they dispense.
Prescription Drugs approved for self-administration (e.g., oral or self-injectable drugs) are excluded when obtained from a Physician or other Provider unless the provider is contracted with Our pharmacy Benefit manager.
For information on how to file Claims for foreign Prescription Drug purchases, the Member should contact Us or Our pharmacy Benefit manager at the telephone number indicated on the Member’s ID card.
Most Members receive information from Us by accessing the pharmacy section of Our website, www.bcbsla.com/pharmacy, or request a copy by mail by calling Our pharmacy Benefit manager at the telephone number identified on Your ID card You may also contact Us at the telephone number on Your ID card to ask whether a specific drug is included in Your formulary.
Most Plan Participants receive information by accessing the pharmacy section of the Claims Administrator’s website, www.bcbsla.com/pharmacy or request a copy by mail by calling the pharmacy Benefit manager at the telephone number indicated on the Plan Participant’s ID card.
Prescription Drugs subject to the Step Therapy program when the Step Therapy program was not utilized or the drug was not approved by Us or Our pharmacy Benefit manager; bb.
The Claim form should then be sent to Our pharmacy Benefit manager, whose number is on Your ID card.