This showed up in today’s mail.. courtesy of my national pharmacy association NCPA ( National Community Pharmacists Association..
It would seem that this Pharmacist got harassed by the PBM because he/she declined to bill a compounded prescription to the pt’s insurance because the reimbursement was $75 BELOW the cost of ingredients… and bill the pt as a denied/non covered Rx..
This is the very example of what I have been talking about .. a pharmacy being part of a health insurance /PBM network and refusing to bill the insurance company for the medication and insisting that the pt pays CASH.
I am not sure how this would apply to a pharmacy that just declines to fill a legit/on time/medically necessary Rx.. BUT.. IMO.. they are similar issues.
Click on the image to make it more readable…
and here Rxforcash is a *.pdf copy.. feel free to share it with anyone that could benefit from the information..
Filed under: General Problems
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