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RxAdvance Important Notice

Date: 06/27/19

THIS INFORMATION IS OUT OF DATE. DO NOT RELY ON THIS INFORMATION.

 

IMPORTANT NOTICE: Prior Authorization (PA) & Pharmacy Network Changes

Effective August 1, 2019, Peach State Health Plan’s pharmacy benefit manager, Envolve Pharmacy Solutions, will be changing their claims processor to RxAdvance. With that change, enhancements are being made to the retail medication PA submission process and pharmacy network for the Peach State Health Plan members for Georgia Families® Medicaid, PeachCare for Kids® and Planning for Healthy Babies® members.

What does that mean for prescribers? Here are the changes:

  • New Fax Number for retail pharmacy PA forms: 1-877-386-4695
  • RxAdvance will oversee the pharmacy network. Any members impacted by a network change will receive a letter suggesting alternate pharmacy locations.
  • Members are receiving new ID cards reflecting the new fax and claim processing information.

Most of Pharmacy Benefit processes will stay the same:

  • The PA phone number for verbal submission or to ask for a Peer-to-Peer will NOT be changing: 1-866-399-0928
  • CoverMyMeds.com will still be the preferred method to submit a secure electronic PA request: CoverMyMeds.com/EPA/EnvolveRx
  • Peach State Health Plan’s Pharmacy department and Envolve Pharmacy Solution continue to oversee the Preferred Drug List (PDL)  medications. PA criteria is not changing.

Peach State Health Plan will work with you to make sure you experience as little disruption to your workflow as possible. We are notifying members of the change, as well.

If you have any questions, please contact Provider Services at 1-866-874-0633. Our staff is here Monday through Friday from 7:00 AM to 7:00 PM EST.

Thank you for your participation in our network and for your dedication to the health of our members.

Sincerely,

Peach State Health Plan

Pharmacy Department