Simple. Quick. Informative

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.