Pharmacy benefit manager changes to IngenioRx
Category: Cal MediConnect
Earlier this year, we announced the launch of IngenioRx, our new pharmacy benefits manager (PBM). Effective January 1, 2020, IngenioRx will start serving our Anthem Blue Cross members’ prescription drug coverage.
With the transition to the new PBM, Anthem Blue Cross Cal MediConnect Plan (Medicare‑Medicaid Plan) members will receive new ID cards containing all the information needed to process claims and access member services. Members will need to use their new ID cards to fill prescriptions beginning January 1, 2020.
Members who fill mail order prescriptions will need to fill their prescriptions with IngenioRx beginning January 1, 2020. We will automatically transfer member mail order prescriptions to IngenioRx home delivery pharmacy for members currently using Express Scripts Mail Order Pharmacy. Members will receive further instructions by mail on initiating IngenioRx home delivery pharmacy services.
Members who now fill their specialty drugs with Express Scripts’ Accredo will have a few choices of specialty pharmacy providers. Members may:
- Keep Accredo as their specialty pharmacy.
- Transfer their specialty pharmacy prescriptions to the new IngenioRx Specialty Pharmacy.
- Select another participating specialty pharmacy.
Members will receive information by mail about their specialty pharmacy options, including further instructions on initiating IngenioRx specialty pharmacy.
It is expected that most members will be able to continue using their current retail pharmacy. In the event a member’s retail pharmacy is not in the new pharmacy network, we will notify the member directly.
Controlled substances and compound prescriptions
Prescriptions for controlled substances, currently filled by Express Scripts Mail Order Pharmacy, cannot be transferred to another pharmacy under federal law. Members currently receiving these medications, who will use IngenioRx for their mail order provider, will need a new prescription sent to IngenioRx. Compound prescriptions are also nontransferrable and will require a new prescription.
Please see attached for contact information.
You can confirm whether your patient has transitioned to IngenioRx through the Availity Portal.
Your patient’s PBM information can be located in the Patient Information section of their patient profile as part of the eligibility and benefits inquiry.
If you have immediate questions, you can contact the Provider Service phone number on the back of your patient’s member ID card or call the number you normally use for questions.
January 2020 Anthem Blue Cross Provider News - California