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When your goal is to provide timely, comprehensive service to your customer, you need answers fast.
- Eligibility – What are the specifics of a member's eligibility?
- Claims – Can I check a member's claims data?
- Rx plan details – Is this medication covered?
With the three self-service pharmacy tools below, you can find out what you need to know quickly and accurately.
Member Eligibility
To check a member's eligibility, you'll need some member identifying information, such as:
- Member's ID number, or
- Member's name, date of birth, and state, or
- A social security number
Claims Search
Search for a claim with either of these:
- Member ID number
- Rx number and date of service.
Drug Coverage & Pricing
Search to see if a drug is covered under the member's plan – using the member's ID number and the drug name.
Prior Authorization Status
Check the status of a claim requiring Prior Authorization – using the member's ID number and the drug name.
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