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To: IPA Members From: Heather Rodgers 5/15/07 1. HORIZON NJ HEALTH MAC INCREASE Horizon NJ Health has increased the MAC price on Urea 40% Cream from $0.35/g to $0.61/g. The effective date for this increase is May 5, 2007. If you filled any prescriptions for this product you may reverse and resubmit these claims for proper reimbursement.
2. NJ MEDICAID DUAL ELIGIBLES AND ANTHEM If you are billing a claim for a Medicaid Dually Eligible patient (who returned a “no match” on the E1 Query), the claim should be billed to Anthem using the following plan information: BIN: 610575 PCN: CMSDUAL2 Member ID: HIC Number Group: Medicaid ID number You may also contact the Anthem Prescription Pharmacy Help Desk at 1-800-662-0210.
3.INNOVIANT OXYCODONE 20MG MAC INCREASE The MAC price on Oxycodone 20mg has been increased to $2.05/per tablet. The effective date for the new MAC is May 9, 2007. If you have filled any claims for this product, you can reverse and resubmit for additional reimbursement. (Innoviant processes claims for the DC37 plan.)
If you have any questions or third party issues, please contact Heather Rodgers at 800-575-2667. |