The Prime Therapeutics Provider Portal offers healthcare professionals a comprehensive digital platform designed to streamline pharmacy and medical resources, enhance patient care, and simplify administrative processes. This portal serves as a critical tool for providers seeking efficient management of pharmaceutical and healthcare services.
Official Links
What Providers Can Do
The Prime Therapeutics Provider Portal provides access to multiple critical resources:
Key Functional Areas
- Medical pharmacy solution management
- Pharmacy benefit management
- Prior authorization processing
- Electronic prior authorization
- Formulary access
- Credentialing
- Compliance training
- Drug pricing information
- Network reimbursement identification
Access and Login
Login Options
Providers can access the portal through dedicated login portals specifically designed for:
- Pharmacy and Provider Resources
- Clients and Health Plans
Features and Services
Comprehensive Provider Support
- 24-Hour Contact Center
- Electronic Tools
- Electronic prior authorization
- Check inquiry systems
- Specialized Resources
- Commercial formularies
- Medicaid processing requirements
- Specialty drug management lists
- Vaccine program information
Specialized Pricing Appeals
Providers have multiple channels for maximum allowable cost (MAC) pricing appeals:
- Email: [email protected]
- Fax: 877-823-6373
- Phone: 888-277-5510 (Option 1, Monday-Friday 6:00 AM – 2:00 PM PST)
- Mail: Attn: MAC Appeal, 2900 Ames Crossing Road, Eagan, MN 55121
Privacy and Security
Compliance Commitment
- Offers detailed compliance training
- Provides options to report compliance concerns
- Maintains robust privacy policies
- Ensures nondiscrimination practices
State-Specific Provisions
The portal recognizes unique requirements for different states, including specialized appeal processes for:
- Arkansas Pharmacies
- New Mexico Pharmacies
- Tennessee Pharmacies
- Washington Pharmacies
Support and Contact
Key Contact
Scott Verley
Director of Financial Modeling
- Email: [email protected]
- Phone: 612-777-2532
Unprovided Information
While the portal offers extensive resources, specific details about mobile app availability are not explicitly mentioned in the provided sources.
The Prime Therapeutics Provider Portal represents a robust, comprehensive digital platform empowering healthcare providers with efficient tools, resources, and support mechanisms for optimal pharmaceutical and medical service delivery.
Disclaimer
Information accurate as of July 2024, sourced directly from Prime Therapeutics official documentation.
Keywords
- Prime Therapeutics provider portal
- Healthcare provider resources
- Pharmacy benefit management
- Electronic prior authorization
FAQ
Does Blue Cross Blue Shield own Prime Therapeutics?2011: GuidedHealth®, a leading-edge clinical intelligence hub, helps members and clinicians make better decisions based on Prime’s unique pharmacy and medical data. 2010: Blue Cross and Blue Shield of Alabama joins Prime as an equity owner.
Is Magellan RX now Prime Therapeutics?Beginning October 1, 2024, Magellan Rx Management will be renamed “Prime Therapeutics Management.” They will manage the Horizon Medical Injectable Program.
Is Prime Therapeutics the same as Walgreens specialty pharmacy?In January, Walgreens announced its plan to purchase Prime Therapeutics’ interest in Alliance Rx Walgreens Prime, making them the sole owner of the company. As part of the agreement, effective June 2022, the company will be known as AllianceRx Walgreens Pharmacy.
Is Prime Therapeutics the same as Accredo?BCBSTX, as well as several independent Blue Cross and Blue Shield Plans, has an ownership interest in Prime Therapeutics. Accredo is contracted to provide services for BCBSTX. Accredo is a trademark of Express Scripts Strategic Development, Inc.
https://www.primetherapeutics.com/providers-and-physicians
Access comprehensive resources that support whole-person health · Medical pharmacy solutions · Pharmacy benefit management. You’re the link between our members
https://www.primetherapeutics.com/pharmacy-provider-tools
Access Prime’s: Log in | Sign up. A pharmacy may submit a MAC pricing appeal via: If the claim is hitting an Express Scripts contract between the pharmacy and