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Drug Plan Information for Providers

Resources

Click below for more information about the prescription drugs available in each category.

Important Points to Remember:
 
  • The printed version may not contain the most current formulary information
  • Medications requiring prior authorization are shaded on the formulary
  • Some over-the-counter drugs are covered by the drug plan
For Updates and Assistance:
 
  • Benefit coverage questions may be directed to Member Customer Service line
  • Providers and pharmacies can contact our Provider Customer Service line
  • Prior authorization questions may be directed to MedImpact at 888.728.5057
     

Copay Offset Program

Health Tradition members have access to manufacturer copay offset for their specialty medication(s). This is intended to lower the upfront net cost to members and their insured groups.

Many of the manufacturer programs will reimburse the member copay offset amount directly to the provider. Once the provider enrolls a member, they will be provided with quick and direct reimbursement.

This program is specific to each member and does not represent a change in contracted rates.

What does this mean for you? 
 
  • Billing: The Provider should continue to purchase and bill the health plan for the specialty medications administered.
  • Manufacturer Copay Offset: To be paid directly from the manufacturer for the copay offset amount, the provider must complete the manufacturer enrollment documentation and submit member information to the manufacturer.
  • Member Copay: Members should not be balance billed or billed for the copayment(s) offset amounts. Amounts should be paid through the manufacturer copay offset program.
  • Program Details: The manufacturer copay offset program is managed in partnership between MedImpact and Archimedes. Our goal is to support you in enrollment.
  • Enroll: Call Archimedes at 888.920.3256 or email Hitouchmedmgmt@archimedesrx.com to complete necessary documentation with the drug manufacturer’s copay offset program.
  • Submit: Submit the provider remittance advice to the manufacturer after each service or claim.

If you have any questions, please call or email Archimedes at 888.920.3256 or Hitouchmedmgmt@archimedesrx.com.