[MyOEBB] ODS mailing Re: pharmacy changes

[MyOEBB system updates]

Dear Business Managers and Benefits Administrators:

 

Last week ODS Pharmacy Services mailed some letters explaining various
changes to their affected OEBB members. Below are the highlights of the
various communications.

 

Specialty Rx Transition

*         Beginning April 1, 2012, BioScrip will no longer provide
specialty or mail-order pharmacy services for OEBB members enrolled in
ODS pharmacy plans. The letter explains that:

o   On behalf of the Oregon Prescription Drug Program (OPDP), ODS has
contracted with Diplomat Specialty Pharmacy to fill prescriptions that
are categorized as specialty prescriptions.  Diplomat has committed to
calling members currently using BioScrip to begin the registration
process and to notify each member's physician. 

o   Postal Prescription Services (PPS) will be handling all of the
mail-order pharmacy prescriptions.  PPS is a current mail-order pharmacy
option available to members, located in Portland, OR.  

 

Plan 9 Claims Processing Changes

*	To make the claims process easier, Plan 9 prescription benefits
will now be processed at the point of service when prescriptions are
being dispensed by participating pharmacies.  Beginning April 1, 2012
member's 20 percent coinsurance will be applied by the pharmacy, after
the deductible has been met.
*	Members with dual coverage may also have their secondary
coverage processed immediately at participating pharmacies. Members will
need to present insurance information for both plans and ask if the
pharmacy has the capability to process a coordination of benefits (COB)
transaction. The plan will pay up to what would have been covered had
the claim been submitted to ODS for primary coverage processing.
*	Prescription drug benefits will be applied to Plan 9 the same as
they are applied to the other OEBB-ODS  plans, including such things as
quantity maximums and step therapy.  Members may refer to their Member
Handbooks for additional information.

 

Additional information such as participating pharmacies, member
handbooks and frequently asked questions are available by visiting
www.odscompanies.com/oebb/.  If you have further questions about these
changes, please contact ODS Pharmacy Services directly at 866-923-0411.

 

Jackie Cowsill

Communications Coordinator

Oregon Educators Benefit Board

Voice: (503) 378-5353

Fax: (503) 378-5832

 

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