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Frequently Asked Questions
What is PrecisionRx Specialty Solutions?
 | PrecisionRx Specialty Solutions is a full-service specialty mail pharmacy created to more effectively manage and monitor the distribution of specialty drugs. |
| PrecisionRx Specialty Solutions offers a robust support program including a team of personal care coordinators, pharmacists and nurses to help your patients taking specialty medications achieve the best possible outcomes from their treatments. |
How will it help my office staff and me?
In addition to the streamlined ordering process, the PrecisionRx Specialty Solutions program offers a host of advantages over other supply systems. For example:
| Supplies physicians with injectable drugs on a per patient basis with no physician cash outlay eliminating the need to stock and bill the health plan or the patient for most high-priced injectable drugs. |
| Verifies reimbursement and eligibility issues. |
| Facilitates prior authorization from the health plan when necessary. |
| Individually labels each shipment for the specific patient. |
| Includes ancillary products like needles, syringes, etc. with many medications at no additional cost. |
How does this program benefit my patients?
PrecisionRx Specialty Solutions collaborates with the prescribing physician, pharmacist and patient to more effectively manage your patient’s medication and condition including:
| One-on-one service and support from a personal care coordinator. |
| Answers to questions like “what to expect from treatment, drug interactions or side effects.” |
| Working closely with the patient to help coordinate patient-physician follow-up. |
| Providing administration supplies like needles, syringes, etc. with many medications at no additional cost. |
| Proactive calls designed to schedule timely refills, educate and monitor drug regimens and encourage therapy adherence. |
| Convenient customer service hours to help with benefit inquiries, claim information and prescription order refills. |
| Access to medication assistance programs that help ensure certain vital medications are available to those individuals in need. |
What Medical Assistance Programs are available for the uninsured or underinsured?
Medication Assistance Programs assist uninsured or under-insured individuals in securing life-saving or life-sustaining medications.
How will patient care coordination be handled?
Each specialty pharmacy participant will be assigned a dedicated personal care coordinator with the following duties:
| Serves as the patient’s gateway to the entire specialty staff of clinical pharmacists, nurses and reimbursement specialists. |
| Educated on the patient’s medication and ancillary needs, the patient care coordinator will assist the patient throughout care. |
| Proactively calls the patient before a refill is due. This is designed to help improve compliance and convenience for the participant. |
| Tracks prior authorizations and pre-certifications and helps to initiate new authorizations when due. |
| Schedules clinical nurse assessments based on the patient’s medication or condition. |
Physician offices simply need to fax the Enrollment Fax Form and a copy of the patient’s insurance card to 1- 800-824 2642 or call 1- 800-870-6419 to start the process. Orders can be placed Monday–Friday, 8 a.m.–10 p.m., Eastern Time.
How much time is needed to get medications?
Prescriptions received by PrecisionRx Specialty Solutions are processed according to the “need by” date determined by the patient or physician. The date medication is needed should be included in the initial request.
How will I receive the medication?
Packages are shipped directly to the physician’s office or to the patient’s home, depending on the physician’s request.
How will I receive temperature-sensitive medications?
Temperature-sensitive medications are shipped in temperature-moderating containers as indicated by the manufacturer. PrecisionRx Specialty Solutions will also coordinate overnight shipping to any location within the continental United States.
What happens if drugs are lost in shipment or delayed?
| Any delay in shipment is communicated to the physician or patient as soon as it is identified. At that time, a new “need by” date is set between the personal care coordinator and the physician or patient and the order is processed based on the new date and expedited with highest priority. |
| Orders are shipped via UPS and can be tracked to avoid being lost in shipment. |
Where do I get prior authorization documentation?
PrecisionRx Specialty Solutions will facilitate the prior authorization process with the health plan. If additional information is required for authorization, a form will be faxed to the physician’s office to complete and return to the prior authorization department for review.
Where do I send prior authorization documentation?
Prior authorization documentation and prescription(s) should be faxed to PrecisionRx Specialty Solutions at 1-800-824-2642 where a specialist verifies patient eligibility and facilitates any necessary authorizations from the health plan.
Do I follow the same process for both medical and pharmacy claims?
Yes. Benefits are verified for all orders processed by PrecisionRx Specialty Solutions.
Can I use PrecisionRx Specialty Solutions for all of my patients regardless of their insurer?
PrecisionRx Specialty Solutions is a network provider for WellPoint-affiliated health plans and many other insurers. The patient and/or physician should verify the network providers for their plan. Please call 1-800-870-6419 to verify eligibility.
How may I obtain more information about the PrecisionRx Specialty Solutions program?
If you have any questions about the PrecisionRx Specialty Solutions program, please call us at 1-800-870-6419, Monday–Friday, 8 a.m.–10 p.m., Eastern Time. For speech and hearing impaired assistance (TDD/TTY), please call 1-800-221-6915, Monday through Friday, 8:30 a.m. to 5 p.m. Eastern Time.
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