Examples of Covered Prescription Services in a sentence
Subrogation — To the extent permitted under applicable law and the applicableBenefit Plan, the Administrator reserves the right to recover benefits paid for a Member’s Covered Prescription Services when a third (3rd) party causes the Member’s injury or illness.
Medicaid claims (OptumRx BINs Only)Unless otherwise specified below, Prescription Drug Compensation for Compounded Drugs dispensed to Medicaid Members that are Medicaid Covered Prescription Services will be at the Network Pharmacy Provider’s agreed upon Prescription Drug Contracted Rate for each approved ingredient submitted for the applicable network associated with the Claim submission, plus a Compounded Drug dispensing fee.
This section shall be considered a part of the Agreement by and between Administrator and Network Pharmacy Provider (including all amendments, addenda or Compensation Exhibits) to the extent the Network Pharmacy Provider provides Covered Prescription Services to Members in applicable states.
Some Covered Prescription Services may have additional requirements or limits that help ensure safe and effective use.
Failure to submit all Part D Covered Prescription Services may impact Part D Sponsor’s STAR ratings as well as individual Medicare Drug Plan Member’s benefit calculations.
Medicare Part D claims (OptumRx BINs Only)The Prescription Drug Compensation for Compounded Drugs dispensed to Medicare Part D Members that are Medicare Part D Covered Prescription Services will be at the Network Pharmacy Provider’s agreed upon Prescription Drug Contracted Rate for each approved ingredient submitted for the applicable network associated with the Claim submission, plus a Compounded Drug dispensing fee.
A major example in a film set in Greco-Roman antiquity, although not a mys- tery, occurs with the detailed overview of the racetrack in William Wyler’s Ben-Hur (1959).
Network Pharmacy Providers shall at all times submit Part D Covered Prescription Services to Medicare Drug Plan Members via the POS System to Claims Processor and furnish Part D Covered Prescription Drugs in a manner that permits the Part D Sponsor to comply with Medicare laws and regulations.
Certain state or local jurisdictions may impose a tax on Covered Prescription Services.
However, LTC Network Pharmacy Providers must have delivery logs, manifests or other Administrator approved proof of delivery of Covered Prescription Services to facilities readily available during an audit.Abuse of the Short Cycle Dispensing regulations as defined by CMS and implemented on 1/1/2013, will be subject to audit and recovery of overpayments resulting from abuse and any attempt to achieve multiple dispensing fees based on days’ supply manipulation.