What’s included in The Record’s Pharmacy category

We recently received some questions about Record articles included in the newsletter’s Pharmacy category. The Pharmacy category is used for articles pertaining to both pharmacy drugs and medical benefit drugs. Our Pharmacy Services department manages both the pharmacy drug benefit and the medical drug benefit for members.

However, as you know, medical drugs are billed as medical claims because they’re administered by health professionals. Drugs purchased by our members at a pharmacy are billed by the pharmacy that dispenses the drug.

Drug‑related articles also may appear in other categories to reflect where they’re being billed and administered. For example, they may be included in the Professional category or the Facility category or both, depending on whether they’re billed by doctor’s offices, hospitals or both. That’s because we want to be sure that billers know of any changes related to these drugs and how we cover them.

Our Record newsletter is organized by category, including Professional, Facility, Pharmacy, DME and All Providers. The All Providers category is used for articles that are likely to be of interest to all our providers. Each issue of the newsletter doesn’t necessarily include articles in every category.

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