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September 2019, Members have the right to free language services for. health care needs We provide free language,services including. 24 hour access to an interpreter When members, call to make an appointment or talk to their personal. physician if needed we will connect them to a,telephonic interpreter. Translation services Some member materials are,available in the member s preferred language.
Bilingual physicians and staff In some medical, centers and facilities we have bilingual physicians to. assist members with their health care needs, They can call Member Services or search online in the medical staff directory at kaiserpermanente org. Braille or large print Blind or vision impaired members can request for documents in Braille or large print. or in audio format, Telecommunications Relay Service TRS If members are deaf hard of hearing or speech impaired. we have the TRS access numbers that they can use to make an appointment or talk with an advice nurse. or member services representative or with you, Sign language interpreter services These services are available for appointments In general advance. notice of two or three business days is required to arrange for a sign language interpreter availability. cannot be guaranteed without sufficient notice, Video Remote Interpretation VRI VRI provides on demand access to American Sign Language.
Spoken Language interpretation services at medical centers for members It meets the need in the care. experience of walk in deaf patient and those in need of urgent care. Educational materials Health education materials can be made available in languages other than. English by request To access Spanish language information and many educational resources go to. kp org espanol or kp org to access La Gu a en Espa ol the Guide in Spanish Members can also look for. the symbol on the English language Web page The points to relevant Spanish content available in La. Gu a en Espa ol, Prescription labels Upon request the Kaiser Permanente of the Mid Atlantic States pharmacist can. provide prescription labels in Spanish for most medications filled at the Kaiser Permanente pharmacy. At Kaiser Permanente we are committed to providing quality health care to our members regardless of their. race ethnic background or language preference Efforts are being made to collect race ethnicity and. language data through our electronic medical record system HealthConnect We believe that by. understanding our members cultural and language preferences we can more easily customize our care. delivery and Health Plan services to meet our members specific needs. Currently when visiting a medical center members should be asked for their demographic information It is. entirely the member s choice whether to provide us with demographic information The information is. confidential and will be used only to improve the quality of care The information will also enable us to. respond to required reporting regulations that ensure nondiscrimination in the delivery of health care. Diversity Continued on page 3,September 2019,Diversity Continued from page 2. We are seeking support from our practitioners and providers to assist us with the member demographic. data collection initiative We would appreciate your support with the data collection by asking that you and. your staff check the member s medical record to ensure the member demographic data is being captured If. the data is not captured please take the time to collect this data from the member The amount of time. needed to collect this data is minimal and only needs to be collected once Recommendation for best. practices for collecting data is during the rooming procedure. In conclusion research has shown that medical treatment is more effective when the patient s race. ethnicity and primary language are considered, To access organization wide population data on language and race please access the reports via our. Community Provider Portal at providers kp org mas under News and announcements To obtain your. practice level data on language and race please email the Provider Relations Department at. Provider Relations kp org, 2019 Utilization Management Affirmative Statement for. Health Plan Staff and Practitioners, Kaiser Permanente practitioners and health care professionals.
make decisions about which care and services are provided. based on the member s clinical needs the appropriateness of. care and service and existence of Health Plan coverage. Kaiser Permanente does not make decisions regarding hiring. promoting or terminating its practitioners or other individuals. based upon the likelihood or perceived likelihood that the. individual will support or tend to support the denial of benefits. The Health Plan does not specifically reward hire promote or. terminate practitioners or other individuals for issuing denials of. coverage or benefits or care, No financial incentives exist that encourage decisions that. specifically result in denials or create barriers to care and. services or result in underutilization In order to maintain and. improve the health of our members all practitioners and health. professionals should be especially diligent in identifying any. potential underutilization of care or service,Online Affiliate. Register today for access to Online Affiliate at providers kaiserpermanente org With Online Affiliate you. can get claims status view eligibility review benefits get referrals in real time view and print remittances. and view electronic medical records clinical staff only For questions contact Patricia Roberts Bradley at. patricia x Roberts kp org or 301 816 6554,September 2019. Haymarket Crossroads Medical Center Opening October 7. Opening Monday October 7 2019 the Haymarket, Crossroads Medical Center will be our newest center in. Virginia and third new center this year The Haymarket. Crossroads Medical Center will be located at 15050. Heathcote Blvd Haymarket VA 20169 It includes more. than 36 000 square feet of medical office space,Services will include primary care obstetrics and.
gynecology radiology laboratory pharmacy optometry. and optical services and mental health and wellness. Case Management,The case management services of Kaiser Permanente. Mid Atlantic States strive to empower members to,achieve the highest possible health outcomes by. coordinating health care services across the continuum of. Our case managers provide the following types of non. emergency assistance, Coordination of care due to complex medical conditions. Provision of support related to a newly diagnosed medical problem. Advice and referral for a range of issues including medical and social domains that may impact a. member s health care and close monitoring of members who experienced a recent increase in hospital. admissions or urgent care visits, Proactive calls by the case management team to remind members of important health screenings to. discuss gaps in care or remind a member when it is time to see a practitioner for a health assessment. KP HealthConnect referrals should be made to case management using the case management order set. and in accordance with the referral guidelines that are outlined therein Practitioners that do not have access. to KP HealthConnect may refer by calling the self referral Line 301 321 5126 or toll free at 866 223 2347. Providers must include the main reason for referral Referrals will be reviewed and directed to the most. appropriate case management resource, The self referral phone line is available for any member who would like to be evaluated for enrollment in the.
Case Management Program The member or caregiver may call either the 301 321 5126 or toll free at 866. 223 2347 A message will prompt the member or caregiver to state their name phone number and Kaiser. Permanente medical record number It s that easy The member or caregiver will then be contacted by. telephone within 24 to 48 hours Enrollment into case management takes 3 to 5 business days Enrollment. in any of the case management programs including the Complex Case Management is voluntary and may. be discontinued by the member at any time,September 2019. Referring Patients to Kaiser Permanente for Specialty Care. Referring your patients to Kaiser Permanente brings the advantages of the integrated care experience to. our members as well as to you the Participating Provider Members referred to Kaiser Permanente. providers for specialty care are seen by Mid Atlantic Permanente Medical Group P C physicians With our. recent expansions in specialty care services members referred to a specialist within Kaiser Permanente. are frequently seen more quickly than those referred to a specialist within our Participating Provider. Network In addition all services rendered at a Kaiser Permanente medical center including lab pharmacy. and radiology orders are documented within KP HealthConnect our state of the art electronic medical. record and care management system The electronic capabilities and technology available through KP. HealthConnect allow us to keep you and the patient connected with all aspects of the care that he she. receives within Kaiser Permanente Members may access health information related to their Kaiser. Permanente care at kp org Participating PCPs with access to KP HealthConnect AffiliateLink have real. time access to their patient s encounters visits charts lab results and more via the web at. providers kp org mas, If you do not have access to KP HealthConnect or Online Affiliate and would like to enroll you may. download an enrollment package at providers kp org mas or contact Provider Experience at 877 806. 7470 for assistance,September 2019,Provider Access to Health Education Materials. Kaiser Permanente physicians and network providers have access to all health education materials to. provide to patients as part of the After Visit Summary or to supplement discussion from patient visit. Content can be viewed through the centralized internal Clinical Library which is an electronic inventory of. health education information that can be used for all visit types Health education content and links to. education videos are also embedded into KP HealthConnect for inclusion in member After Visit Summary. sent via secure messaging or mailed directly to patient s addresses For health education programs. providers can, Refer or direct book members into some health education programs through the eConsult system. Using KP HealthConnect After Visit Summaries or hard copy flyers provide members with information. on how to self register for programs, Additional information on health education programs tools and resources is available by.
Visiting kp org healthyliving mas, Contacting the Health Education automated line 301 816 6565 or toll free at 800 444 6696. Advance Directives, An Advance Directive is a legal document that allows members to. make treatment preferences for serious or sudden health events It. also lets the member identify a health care surrogate For. additional details on Advance Directives and Advance Care. Planning and Life Care Planning services please visit. kp org lifecareplan,Adopting Emerging Technology for UM Referral. Management, Medical research identifies new drugs procedures and devices that can prevent diagnose treat and cure. diseases The Kaiser Permanente Technology Review and Implementation Committee TRIC collaborates. with the Kaiser Permanente Interregional New Technologies Committee INTC and Emerging Therapeutics. Committee to assist physicians and patients in determining whether a new drug procedure or device is. medically necessary and appropriate TRIC recommends the inclusion or exclusion of new technologies as. covered benefits to Health Plan and tracks inquiries for medical technology assessment Together they. provide answers to important questions about indications for use safety effectiveness and relevance of. new and emerging technologies for the health care delivery system. The INTC is comprised of physicians and non physicians across Kaiser Permanente If compelling scientific. evidence is found indicating a new technology is comparable to the safety and effectiveness of currently. available drugs procedures or devices the committee will recommend the new technology be implemented. internally by Kaiser Permanente and or authorize for coverage from external sources of care for its. indication for use This technology assessment process is expedited when clinical circumstances merit. urgent evaluation of a new and emerging technology. September 2019,Member Rights Responsibilities,Members of Kaiser Permanente have the right to.
Receive information that empowers you to be involved in health care decision making This includes. your right to, Actively participate in discussions and decisions regarding your health care options. Receive and be helped to understand information related to the nature of your health status or condition. including all appropriate treatment and non treatment options for your condition and the risks involved. no matter what the cost is or what your benefits are. Receive relevant information and education that helps promote your safety in the course of treatment. Receive information about the outcomes of health care you have received including unanticipated. outcomes When appropriate family members or others you have designated will receive such. information, Refuse treatment providing you accept the responsibility and consequences of your decision. Give someone you trust the legal authority to make decisions for you if you ever become unable to make. decisions for yourself by completing and giving us an Advance Directive a durable power of attorney for. health living will or other health care treatment directive You can rescind or modify these documents at. Receive information about research projects that may affect your health care or treatment You have the. right to choose to participate in research projects. Receive access to your medical records and any information that pertains to you except as prohibited by. law This includes the right to ask us to make additions or corrections to your medical record We will. review your request based on HIPAA criteria to determine if the requested additions are appropriate If. we approve your request we will make the correction or addition to your protected health information If. we deny your request we will tell you why and explain your right to file a written statement of. disagreement You or your authorized representative will be asked to provide written permission before. your records are released unless otherwise permitted by law. Receive information about Kaiser Permanente and your plan This includes your right to. Receive information in languages other than English in large print or other alternative formats. Receive the information you need to choose or change your Primary Care Physician including the name. professional level and credentials of the doctors assisting or treating you. Receive information about Kaiser Permanente our services our practitioners and providers and the. rights and responsibilities you have as a member You also can make recommendations regarding Kaiser. Permanente s member rights and responsibility policies. Receive information about financial arrangements with physicians that could affect the use of services. you might need, Receive emergency services or Part D drug when you as a prudent layperson acting reasonably would. have believed that an emergency medical condition existed. Receive covered urgently needed services when traveling outside Kaiser Permanente s service area. Receive information about what services are covered and what you will have to pay and to examine an. explanation of any bills for services that are not covered. Member Rights Responsibilities Continued on page 8. September 2019, Member Rights Responsibilities Continued from page 7. File a complaint grievance or appeal about Kaiser Permanente Part D drug or the care you received. without fear of retribution or discrimination expect problems to be fairly examined and receive an. acknowledgement and a resolution in a timely manner. Receive professional care and service This includes your right to. See plan providers get covered health care services and get your prescriptions filled within a reasonable. period of time and in an efficient prompt caring and professional manner. Have your medical care medical records and protected health information handled confidentially and in a. way that respects your privacy,Be treated with respect and dignity.
Request that a staff member be present as a chaperone during medical appointments or tests. Receive and exercise your rights and responsibilities without any discrimination based on age gender. sexual orientation race ethnicity religion disability medical condition national origin educational. background reading skills ability to speak or read English or economic or health status including any. mental or physical disability you may have, Request interpreter services in your primary language at no charge. Receive health care in facilities that are environmentally safe and accessible to all. As a member of Kaiser Permanente you have the responsibility to. Promote your own good health, Be active in your health care and engage in healthy habits. Select a Primary Care Physician You may choose a doctor who practices in the specialty of Internal. Medicine Pediatrics or Family Practice as your Primary Care Physician. To the best of your ability give accurate and complete information about your health history and health. condition to your doctor or other health care professionals treating you. Work with us to help you understand your health problems and develop mutually agreed upon treatment. Talk with your doctor or health care professional if you have questions or do not understand or agree with. any aspect of your medical treatment, Do your best to improve your health by following the treatment plan and instructions your physician or. health care professional recommends, Schedule the health care appointments your physician or health care professional recommends. Keep scheduled appointments or cancel appointments with as much notice as possible. Inform us if you no longer live or work within the plan service area. Know and understand your plan and benefits, Read about your health care benefits and become familiar with them Detailed information about your.
plan benefits and covered services is available in your Evidence of Coverage Call us when you have. questions or concerns, Pay your plan premiums and bring payment with you when your visit requires a copayment coinsurance. or deductible, Let us know if you have any questions concerns problems or suggestions. Member Rights Responsibilities Continued on page 9. September 2019, Member Rights Responsibilities Continued from page 8. Inform us if you have any other health insurance or prescription drug coverage. Inform any network or nonparticipating provider from whom you receive care that you are enrolled in our. Promote respect and safety for others, Extend the same courtesy and respect to others that you expect when seeking health care services. Assure a safe environment for other members staff and physicians by not threatening or harming others. National Drug Codes for Submitted Claims, Based on direction from the Centers for Medicare and Medicaid and the Medicaid State Agencies in.
Maryland and Virginia a National Drug Code NDC and quantity of the drug administered are required on. claims billed for physician administered drugs It was recently discovered that our claim processing system. has been reimbursing Medicaid claims billed with physician administered drugs regardless of whether the. NDC or quantity was included, On September 15 2019 Kaiser Permanente implemented an update to our claim processing system to. provide a soft denial of claims submitted without NDCs and or drug quantities Please ensure that claims. are submitted with appropriate NDCs and quantities to avoid payment delays or denial. September 2019,Pharmacy Updates Drug,Formulary Management. Kaiser Permanente Mid Atlantic States KPMAS has multiple. drug formularies to promote rational safe and cost effective. drug use for our Commercial Medicare Medicaid and,Marketplace Exchange members. Each drug formulary is a list of preferred drugs approved for. use by the KPMAS Regional Pharmacy and Therapeutics. P T Committee The KPMAS P T Committee with expert, guidance from various medical specialties evaluates. appraises and selects FDA approved drugs considered to be. the most appropriate for use within the region,Line of Business Applicable Drug Formulary.
Commercial KPMAS Commercial Drug Formulary,Medicare Part D Medicare Part D Drug Formulary. KP VP VA Medicaid Commonwealth of Virginia Medicaid and FAMIS Preferred Drug List. MD HealthChoice Maryland HealthChoice Preferred Drug List. Note some drugs used for Mental Health Substance Abuse Disorders and HIV AIDS. are excluded from the KPMAS Drug Formulary but covered by Maryland Department. of Health on the Maryland Medicaid Fee For Service Preferred Drug List. Marketplace Exchanges KPMAS District of Columbia Maryland and Virginia Marketplace Formulary. The KPMAS P T Committee is comprised of physicians from primary care and specialty departments. pharmacists and representatives from nursing and quality departments who review objective evidence. based evaluations for the purpose of adding and or deleting drugs from the drug formulary preferred drug. The KPMAS P T Committee promotes the use of generic drugs based on clinical effectiveness safety and. therapeutic equivalence to a branded drug in accordance with all applicable federal state and or local. If an FDA AB rated approved and therapeutically equivalent generic drug becomes available the generic. drug is added to the drug formulary without KPMAS P T Committee review if the brand name drug is. already on the drug formulary and has been reviewed in the past The corresponding brand name drug is. deleted from the drug formulary after review and approval by the KPMAS P T Committee Selected generic. drugs such as hormonal therapy narrow therapeutic index drugs or non formulary drugs may require a. formal review by the KPMAS P T Committee before they are added to the drug formulary. Pharmacy Updates Drug Formulary Management Continued on page 11. September 2019, Pharmacy Updates Drug Formulary Management Continued from page 10. Therapeutic Conversions, Periodically a list of drugs with potential for significant member and organizational cost savings is targeted. for therapeutic conversion The KPMAS Clinical Pharmacy Team in collaboration with the MAPMG. Physician Director of P T Drug Utilization Management develops a standard process for therapeutic. conversion for these agents, This process assures proper communication implementation and education of healthcare providers. pharmacists and KPMAS members about each drug conversion. Upon evaluation if a member qualifies for therapeutic conversion an order is placed to the pharmacy The. member is informed of the therapeutic conversion and asked to call the pharmacy to have the prescription. filled when they are ready, If the member does not agree to the therapeutic conversion has an allergy or adverse reaction to the.
preferred drug or the preferred product is ineffective for the member s treatment a note is placed in the. member s electronic medical record EMR so that the issue of the therapeutic conversion is not revisited. Members who are converted to a new drug will be counseled by the dispensing pharmacist and provided. patient education at the time of drug pick up,KPMAS Formulary Review addition deletion. The drug formularies for each line of business and their corresponding pharmaceutical management. processes are reviewed at least annually, The KPMAS drug formularies are dynamic and updated regularly monthly with any additions and or. deletions approved by the KPMAS P T Committee Updates to the drug formularies are available on the. KPMAS intranet for MAPMG providers and on the KPMAS Clinical Library via the Community Provider. portal for affiliated providers Clinical Departments Specialties Pharmacy Drug Information. Formulary Providers are encouraged to review the drug formulary changes online regularly Any FDA. approved drug may be evaluated for drug formulary addition or deletion and any physician or member may. request a review of a drug, In order to request that a drug be reviewed by the KPMAS P T Committee a Drug Formulary Addition and. Deletion Request form is completed by the requestor and forwarded to the co chairs of the KPMAS P T. Committee along with supporting literature and references. Drug formulary addition deletion requests should include the following. Name strength and dosage form of the drug requested. Reason for the request with clinical references of its safety and effectiveness. The drug it would replace on formulary if any and, Contact information of the requesting physician along with their specialty. Drug Formulary Addition and Deletion Request form is available on the KPMAS intranet for MAPMG. providers and from the KPMAS Clinical Library Clinical Departments Specialties Pharmacy Drug. Information Drug Formulary Addition and Deletion Request Form for affiliated providers. Pharmacy Updates Drug Formulary Management Continued on page 12. September 2019, Pharmacy Updates Drug Formulary Management Continued from page 11.
Based upon the KPMAS P T Committee review a drug or biological will be classified into an appropriate. Formulary drug F A drug including specific strengths and dosage forms reviewed and approved on. the basis of sound clinical evidence that supports the safe appropriate and cost effective use of the. drug May be prescribed by all credentialed prescribers except where state laws and or regulations. Formulary drug with Criteria or Guidelines FC A formulary drug that includes specific criteria for. prescribing and or dispensing Prescribers may prescribe these drugs as long as criteria are met and the. specific criteria are documented in the medical record Criteria must be measurable and operationally. Formulary drug with Restrictions FR A formulary drug with prescribing restricted to specific. prescribers e g specialty departments, Non formulary drug NF A drug not officially accepted for inclusion into the drug formulary This. includes drugs that have been reviewed but not accepted to the drug formulary new drugs not yet. reviewed for addition to the drug formulary a brand strength or dosage form of a drug not approved for. addition to the formulary, Non formulary drug with Criteria or Guidelines NFC A drug that has not been accepted to the. formulary though drug rider coverage for this drug meets specific criteria for use The specific criteria are. documented on the prescription, Non formulary drug with Restrictions NFR A drug that has been reviewed but not accepted into. the formulary Drug rider coverage for this drug meets specific restrictions for use when prescriptions are. written by or are written in consultation with the specific prescribers e g specialty departments. Affiliated providers can keep current with drugs on all KPMAS drug formularies by visiting the KPMAS. Clinical Library Clinical Departments Specialties Pharmacy Drug Information Formulary and. MAPMG providers can search all KPMAS formularies via the intranet Providers are encouraged to check. their respective websites regularly for any changes or updates. A printed copy of each drug formulary is available upon request from the Provider Relations department at. 1 877 806 7470 via the affiliated provider website or via the intranet for MAPMG providers. Quantity limits or quotas, The KPMAS P T Committee may set quantity or refill limits for drugs in the following circumstances. Medication safety concerns, Potential for waste or diversion associated with high cost or.
Drug shortage situations, These limits will be reviewed annually or as appropriate such as in the setting of a drug shortage. The drug formulary also lists drugs for which quantity limits apply as described in the Evidence of Coverage. Drugs with established quantity limits are marked with abbreviation QL in the drug formulary list. Pharmacy Updates Drug Formulary Management Continued on page 13. September 2019, Pharmacy Updates Drug Formulary Management Continued from page 12. Prior Authorizations and Step Therapy, The KPMAS P T Committee may establish prior authorization criteria or step therapy for certain drugs. based on the following, Significant potential for off label indications without data to support wide spread utilization. Significant safety concerns,Significant concerns for abuse or misuse or.
Based on criteria established by Health Plan Kaiser Permanente nationally national treatment. guidelines available for a specific therapy or disease state or state and regulatory mandates. Providers can review the complete list of drugs requiring prior authorizations by reviewing the formularies for. each line of business on the MAPMG intranet site or via the Community Provider Portal. Formulary Changes and Drug Updates, The KPMAS P T Committee publishes drug formulary decisions for all lines of business to ensure that. healthcare providers are kept informed with the most recent updates to each drug formulary These updates. are published monthly on the MAPMG intranet site or via the Community Provider portal. A printed copy of each drug formulary is available upon request from the Provider Relations department at. 877 806 7470 via the KPMAS Clinical Library or via the intranet for MAPMG providers. Pharmacy Updates Drug Formulary Management Continued on page 14. September 2019, Pharmacy Updates Drug Formulary Management Continued from page 13. Formulary Changes and Drug Updates,The KPMAS P T Committee publishes drug. formulary decisions for all lines of business to ensure. that healthcare providers are kept informed with the. most recent updates to each drug formulary These,updates are published monthly on the MAPMG. intranet site or via the Community Provider portal. A printed copy of each drug formulary is available. upon request from the Provider Relations department. at 877 806 7470 via the KPMAS Clinical Library or,via the intranet for MAPMG providers.
Non formulary exceptions process, The non formulary exception process offers providers and members with access to non formulary drugs and. facilitates prescription drug coverage of medically necessary non formulary drugs as determined by the. prescribing provider, Members can obtain a non formulary drug outside of the exception process at any time by paying full price. for the drug when the prescribing provider deems it is not medically necessary and not harmful but agrees. to prescribe based on patient demand, Please note that Medicare members can request a tiering exception and Marketplace Exchange members. have an open formulary, Highlights of the non formulary exceptions process. Non formulary drugs should be used only if the patient fails to respond to formulary drug therapy or has. special circumstances requiring the use of a non formulary drug. The provider makes the final decision regarding what drug is appropriate for the member If the. appropriate drug is not on the drug formulary and is deemed medically necessary by the provider he she. documents the reason for the medical necessity in the patient s medical record and on the pharmacy. prescription order This documentation is transferred with the prescription to the Kaiser Permanente. pharmacy or network pharmacy for appropriate dispensing. If an affiliated network provider prescribes a non formulary drug without the appropriate exception. reason documented they should expect a telephone call from a pharmacist to suggest a formulary. alternative or to obtain a non formulary exception reason in order for the same documentation to take. place This allows Kaiser Permanente to track the use of non formulary agents and decide whether they. should be re evaluated for drug formulary inclusion. Some reasons why a provider may grant an exception to the formulary include. Allergy adverse reaction to formulary product or,Treatment failure to a formulary drug.
Once the provider chooses a non formulary exception reason the prescription will be covered at the. appropriate co payment, Pharmacy Updates Drug Formulary Management Continued on page 15. September 2019, Pharmacy Updates Drug Formulary Management Continued from page 14. If the provider determines that the non formulary drug is not medically necessary the provider will discuss. the available formulary alternatives with the member If the member insists on the non formulary drug but an. appropriate formulary alternative is available the provider may still prescribe the non formulary drug and. document appropriately, The provider will document the non formulary drug as a patient request demand although not medically. necessary The drug will not be covered under the pharmacy benefit. The member will pay full price for the drug if a non formulary drug is not ordered through KP. HealthConnect there is no exception reason documented and the member presents to a Kaiser. Permanente pharmacy to fill the prescription In this case the following steps will occur. The pharmacist will contact the prescribing provider to discuss a formulary alternative or obtain the. non formulary exception reason, If an appropriate non formulary exception reason is obtained the appropriate co pay will be applied. If a non formulary exception reason is not obtained then the member may get the non formulary drug. filled by paying full price for the drug, The member may request a review of their case through Member Services.
If the provider prescribes a non formulary drug requested by a patient with a network pharmacy benefit. without indicating a non formulary exception and the member goes to a network pharmacy to fill the. prescription the member may do the following, Ask the pharmacist to request a formulary alternative or call the Pharmacy Benefit Manager to start the. process for a non formulary exception, Receive the non formulary drug and pay the standard retail price. Contact Member Services at 877 218 7750 and request a non formulary exception review. The cost of members drugs may vary depending upon the type of product and particular pharmacy benefit. however providers can find general information on member s prescription co payment and coinsurance. information by member benefit plan type on the KPMAS Clinical Library Clinical Departments Specialties. Pharmacy Drug Information Pharmacy Prescription Benefit Grid Summary. If members have questions about their pharmacy benefits please refer them to Member Services or their. Evidence of Coverage document that they received at the beginning of this renewal year. Websites to Bookmark,MAPMG providers, KPMAS Drug Formularies all lines of business can be located at. http pithelp appl kp org MAS formulary html, The Drug Formulary Addition and Deletion Request Form can be accessed at. http pithelp appl kp org MAS phcy therpeutics html. Affiliated Providers via KPMAS Clinical Library at providers kaiserpermanente org html cpp mas. pharmacytoc html You will be asked to sign in with your user ID and password to access the co payment. and coinsurance information If you do not have access to KPMAS Clinical Library and would like to gain. access please contact provider relations at 877 806 7470 Monday through Friday 9 a m to 5 p m EST for.


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December 2015 News Letter - Westie Rescue Network, Inc

December 2015 News Letter Westie Rescue Network Inc

Rowdy Simon Westie Rescue Network, Inc. P.O. Box 884 Lafayette, CO 80026 I am so very proud and grateful to all our volunteers, who without hesitation, give their time and love to our mission to rescue, rehabilitate and rehome our Westies. It is a privilege to work with them every day. To them and all of you I hope that 2016 is your healthiest ...

Datasheet EDIUS Workgroup 8 - Hannu Pro

Datasheet EDIUS Workgroup 8 Hannu Pro

www.grassvalley.com 1 EDIUS Workgroup 8 means more formats and more resolutions in real time for the ability to Edit Anything, Anywhere, whether as a standalone user in the field or within network connected production infrastructures. EDIUS Workgroup 8 is the perfect finishing tool for broadcast news, news maga-

Taneynet TV

Taneynet TV

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Maintenance of Access Network Optical Fibers - IT News Info

Maintenance of Access Network Optical Fibers IT News Info

Maintenance of Access Network Optical Fibers By Hiroshi Goto TABLE OF CONTENTS; 1. Introduction 2. Current Status of Access Networks 3. Fiber Construction Targeting ...

BIM for Sustainable Design - Federal News Network

BIM for Sustainable Design Federal News Network

While many technologies can be used to support BIM, Autodesk Revit Building is purpose-built for BIM and delivers its highest benefits because it is based on parametric building modeling technology, which uses a relational database together with a behavioral model to capture and present building information dynamically.

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Gold Plus Suggestive Bouquet MRP Rs 349 Total

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Yorkshire and the Humber Mental Health Network News

Yorkshire and the Humber Mental Health Network News

Yorkshire and the Humber Mental Health ... Welcome to Issue 16 of the Yorkshire and the Humber Mental Health Network News. ... Findings from the Healthwatch Network.

SHADOW REPORT 2016 - Corruption Watch

SHADOW REPORT 2016 Corruption Watch

SHADOW REPORT 2016 Access to Information Network 369 PAIA requests were made ... http://cer.org.za/news/victory-for-environmental-rights-department-of-

Geography of Jammu & Kashmir State - KOAUSA

Geography of Jammu amp Kashmir State KOAUSA

Geography of Jammu & Kashmir KASHMIR NEWS NETWORK (KNN) 4-5 4 Physical Divisions, Mountains and Passes The State of Jammu and Kashmir falls in the great north-western, complex of the Himalayan ranges with marked relief variation, snow- capped summits, antecedent drainage, complex geological structure and rich temperate flora and fauna.

Decision No: 131/93 AND KAY ELLMERS TV3 NETWORK SERVICES

Decision No 131 93 AND KAY ELLMERS TV3 NETWORK SERVICES

Ms Ellmers' Complaint to TV3 Network Services Limited In a letter dated 13 May 1993, Ms Kay Ellmers of Auckland complained to TV3 Network Services Ltd about an item broadcast on 3 National News and repeated on Nightline on 12 May 1993. The item concerned street violence in Wellington and included a voice-over along the

Spreadsheets Across the Curriculum

Spreadsheets Across the Curriculum

Edit The National Numeracy Network > News/Opportunities > NSF Numeracy Projects Supporting QL in Education > Project Profiles > Spreadsheets Across

Inside Eggs are now naturally - American Egg Board

Inside Eggs are now naturally American Egg Board

well-known publications such as Better Homes and Gardens, Redbook and Every Day with Rachael Ray. Online ads will also reinforce the lower cholesterol and higher vitamin D news and will appear on MSN, Grocery Shopping Network and Google. Additionally, through the Incredible Edible Egg Facebook page, AEB is launching a user-generated virtual ...

Selected Coverage March 2013 - rochester.edu

Selected Coverage March 2013 rochester edu

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The Junction News

The Junction News

to keep them safe. It is preferable that students walking to or from school, do so with other students. Warren Cann, a psychologist and director of the Raising Children Network, a parenting website, says it is important mums and dads find a balance between instilling protective behaviours and creating a fear of all strangers.