Online Prior Authorization Pharmacy CoverMyMeds is an online drug prior

Online prior authorization pharmacy covermymeds is an

This preview shows page 77 - 79 out of 117 pages.

Online Prior Authorization - Pharmacy CoverMyMeds is an online drug prior authorization (PA) program through Envolve Pharmacy Solutions that allows prescribers to begin the PA process electronically. Prescribers locate the correct form, fill it out online, and then submit it to Envolve Pharmacy Solutions via fax. CoverMyMeds simplifies the PA submission process by automating drug prior authorizations for any medication. CoverMyMeds can be found at A pharmacy can provide up to a 72 hour supply of medically necessary outpatient medications by calling the Envolve Pharmacy Solutions Pharmacy Help Desk at 1-888-321-3120. For Participants established on therapy and in need of a continuation Prior Authorization, the pharmacy can provide up to 15 days supply of the medication.
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77 Pharmacy Claim Submission For Envolve Pharmacy Solutions Pharmacy Paper Claim submissions, send correspondence to: Attn: Envolve Pharmacy Solutions Pharmacy Claim Submission 5 River Park Place East, Suite 210 Fresno, CA 93720 Preferred Drug List (PDL) The PA Health & Wellness Preferred Drug List (PDL) can be found online in machine readable format at and describes the circumstances under which contracted pharmacy Providers will be reimbursed for medications dispensed to Participants covered under the program. All drugs covered under the Pennsylvania Medicaid program are available for PA Health & Wellness Participants. The PDL includes all therapies available with and without PA in alignment with CMS covered outpatient medications . The PA list includes those drugs that require Prior Authorization for coverage. The PDL applies to all medications a Participant may receive at network outpatient pharmacies. The PDL is continually evaluated by the Pennsylvania Pharmacy and Therapeutics (P&T) Committee to promote the appropriate and cost-effective use of medications. The Committee is composed of the PA Health & Wellness Medical Director, Pharmacy Director, and several Pennsylvania primary care physicians, pharmacists, and healthcare Providers. Representation will also include physical health consumer as well as behavioral health consumer Participants. The Preferred Drug List does not: Require or prohibit the prescribing or dispensing of any medication Substitute for the independent professional judgment of the Provider or Pharmacist Relieve the Provider or Pharmacist of any obligation to the Participant or others The PA Health & Wellness PDL includes a broad spectrum of generic and brand name drugs. Some preferred drugs require Prior Authorization (PA). Medications requiring PA are listed with a “PA” notation throughout the PDL. A paper copy of the current PDL can be requested by calling Provider Relations department at number provided in the Key Contacts section of this manual.
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  • Fall '19
  • PA Health & Wellness

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