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REMINDER: Prime Therapeutics Is Our New PBM

As we advised you in February, Blue Cross and Blue Shield of North Carolina’s (BCBSNC’s) commercial membership will have a new pharmacy benefits manager (PBM), Prime Therapeutics (Prime), as of April 1, 2012.  Members with Prime as their PBM received new ID cards in March, so please ask your BCBSNC patients for their ID cards during their next visit, so you can update their files accordingly.

What You Need to Know About Prime

  • All pharmacy prior authorizations and patient medication history currently on file with Medco will automatically transfer to Prime Therapeutics (except controlled substances).
  • PrimeMail® is the new mail-order pharmacy program. Please use the Prime fax order form found on the “Forms and Documentation” page of the Provider portal at www.bcbsnc.com, if needed, as of April 1.
  • Prime will contact physicians with BCBSNC commercial members who have controlled substance prescriptions in order to have the script replaced.
  • In the unusual event that Prime doesn’t receive a BCBSNC patient’s record, Prime will work with the sending pharmacy and member to transfer or obtain a new prescription as quickly as possible to avoid any interruption in care.
  • The change to Prime Therapeutics as our new PBM only applies to our commercial group and individual business (excludes Blue Medicare products and the Federal Employee Program).
  • The State Health Plan will remain with Medco as their PBM.

If you have any questions, please contact our BCBSNC Network Management specialists at 1.800.777.1643, or BCBSNC Customer Service via the Provider Blue LineSM at 1.800.214.4844.