We recommend that Plan direct the PBM to modify its claims system to ensure that all mail order pharmacy claims are processed using the copay structure stated in the benefit brochure.
Questioned Costs
$0
Funds for Better Use
$0
Recommendation Status
Closed
Source UUID
9a8cf8fd-31ae-4176-8cae-10c8b5840a63-11
Recommendation Number
11
Significant Recommendation
Yes