• What are our hours of operation?
• How many pharmacies are in the network?
• What states does PharmUcare operate in?

• Why did you receive this card?
• When should you use this card?
• Are all medications approved?
• Can your family members use this card?
• Can you talk to one of our pharmacists if you have a question?

• What source do you use for AWP?
• Do you provide an on-line data link with all pharmacies in your network to convey timely information
  on client plan design, worker eligibility, pricing, and other safety checks or edits prior to dispensing?
• Are you able to receive client eligibility data electronically on a daily basis?
• What is your process for handling preauthorization for prescriptions?
• Do you offer a "first fill" option?
• Will you go at risk for "first fill" prescriptions?
• Do you provide access to licensed clinical pharmacists by claims and nurse professionals?
• Do you charge for access to a professional clinical pharmacist?
• Is our technology SAS 70 Compliant?
• Do you have an established implementation process for a client with an existing pharmacy program?
• Do you provide regular performance and outcomes reports to your customers?

What are our hours of operation?
PharmUcare is physically open Monday through Friday 9:00am - 8:00pm EST. Calls outside of our operating hours are fielded by an offsite call center with full access to our technology platform and are able to assist our clients, pharmacies and injured workers with their needs. In the event further assistance is needed, the call center will forward the call to our on-call specialist.

How many pharmacies are in the network?
PharmUcare has contracts with over 62,000 pharmacies nationwide. This includes every major chain and 9 out of 10 regional and smaller independent pharmacies.

What states does PharmUcare operate in?
PharmUcare operates in all 50 states.

Why did you receive this card?
If you received a prescription card in the mail from PharmUcare, this is due to an injury that occurred on the job. PharmUcare is contracted by your insurance carrier to provide this card to you at no cost.

When should you use this card?
Anytime you need to fill medicatons related to your work-related injury.

Are all medications approved?
Your insurance company may have pre-selected medications that will process without authorization. If you drop off your prescription at the pharmacy and it rejects for any reason the pharmacy will be directed to call PharmUcare. PharmUcare will contact your insurance company for approval of the rejected medication on your behalf. If you would like to know what types of medications are pre-approved please call 866.477.9652 and a PharmUcare representative will be happy to assist you.

Can your family members use this card?
No, this card is only for your injury.

What should you do if there is a problem when using your card?
Your pharmacy should call us with any problems they are having with the card. If for any reason they do not call us, or if you have any questions regarding your medications, please call our customer service team at 866.477.9652.

Can you talk to one of our pharmacists if you have a question?
Yes, our pharmacists are available to answer all of your medication related questions, you can contact our pharmacists by calling 866.477.9652.

What source do you use for AWP?
Blue Book

Do you provide an on-line data link with all pharmacies in your network to convey timely information on client plan design, worker eligibility, pricing, and other safety checks or edits prior to dispensing?
Yes. Every one of PharmUcare's network pharmacies utilize the online system-the technological capability to process prescriptions online is a PharmUcare requirement for pharmacies that participate in the network. This is another indicator of PharmUcare's ability to deliver information real-time, 24/7. We understand that online access ensures transaction and fulfillment accuracy and expediency, as well as the resolution of any issues to expedite the process, allowing injured workers to receive their medications as quickly as possible.

Are you able to receive client eligibility data electronically on a daily basis?
Yes. PharmUcare can receive electronic eligibility files from on a predetermined scheduled basis (eg. hourly, daily, etc…) and load the information into our system.

What is your process for handling preauthorization for prescriptions?
PharmUcare has devised a user-friendly process for efficiently handling prescription pre-authorizations. Pre-authorization rules are set up in the implementation process. Pharmacies receive instant notification of these predetermined pre-authorizations. A simple call to our PharmUcare Help Desk will set this process in motion. Claim adjusters can also utilize our online claims management system, ClaimTrac ™, to manage pre-authorizations on a case-by-case basis.

Do you offer a "first fill" option?
Yes. PharmUcare captures prescriptions at the earliest possible time, either before or just after the First Notice of Injury. We offer programs to ensure that pharmacies dispense the initial prescription of appropriate medications to your injured workers, while eliminating the risk and uncertainty retail pharmacies can experience in processing workers' compensation prescriptions. These proactive programs help to reduce the incidence of first fill claims "slipping" to third-party billers for reimbursement, including premium charges. Additionally, PharmUcare provides critical employer and pharmacy education to facilitate understanding and usage of our program among all parties. The PharmUcare First Fill Program enables injured workers to receive a 5-day supply of appropriate medications at your contracted rate and with no out-of-pocket expense prior to the first notice of injury. In addition, these injured workers are automatically indexed into the PharmUcare system at the point of sale, so that in the future, all transactions can be run through PharmUcare-enabling savings and providing convenience.

Will you go at risk for "first fill" prescriptions?
Yes. PharmUcare assumes 100% of the risk for the first fill. If a claim is denied or not reported PharmUcare accepts liability for any charges incurred with dispensing the initial prescription. You will only be invoiced if and when appropriate eligibility documentation is received through our EDI protocols.

Do you provide access to licensed clinical pharmacists by claims and nurse professionals?
Yes. Through various clinical programs, our professional pharmacists intervene with prescribing physicians and dispensing pharmacies on cases that require special clinical attention. Plus, our team of seasoned clinicians-with PharmD credentials-provides essential data on injured workers, facilitating effective case management and/or other fraud and abuse intervention.

Do you charge for access to a professional clinical pharmacist?
No. As part of our service, we provide a dedicated clinical pharmacist, with PharmD credentials, for consultative support.

Is our technology SAS 70 Compliant?
Yes. We have had a SAS 70 Type II performed in 2008 and are compliant. Our 2009 results should be available by the end of the year. Annual SAS 70 Type II audits are always scheduled.

Do you have an established implementation process for a client with an existing pharmacy program?
Yes. We can immediately implement existing claims, as well as provide quick start up for new claims occurring on or after your program start date. Injured workers are eligible for participation in our adjudication system immediately upon the history/eligibility file being loaded. There are no conversion costs to migrate from your current system to PharmUcare. Based on your specific project variables, our management team will create a timeline to best meet your needs.

Do you provide regular performance and outcomes reports to your customers?
Yes. Our quarterly (or bi-annual) business reviews provide customers with valuable insight into their program's performance, and allows the account team to recommend any changes that may enhance the overall program's performance. In addition, our ClaimTrac™ web-based software allows our clients to have access to real-time information at their fingertips. ClaimTrac™ also has a full, customizable reporting platform to make sure our unique clients have the unique information they need.