If a member has dual pharmacy coverage, will ODS coordinate the pharmacy benefit?
Yes. There are two methods for processing coordination of benefits (COB) claims: electronic submission by the pharmacy or paper submission by the member mailing in a claim (more information is available in the Claims Procedures section of the Member Handbook). The ability for a pharmacy to participate can depend on the capabilities of the pharmacy’s claim submission software.
Related Questions
- How is the Pharmacy Benefit Code, ME019, to be coded in view of some of the Prescription Coverage Mandates in the state of Maine?
- If a member has dual pharmacy coverage and ODS is the secondary plan, how will the secondary claim be paid?
- How do we coordinate benefits for a patient that has dual coverage?
