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OPTUM RX REIMBURSEMENT - ONLINE PROCEDURES AND SUPPORTING DOCUMENTA TlON
TO ALL RETIREES - WITH MONROE TOWNSHIP HEALTH BENEFIT COVERAGE
FROM KEVIN W HEYDEL BUSINESS ADMINISTRATOR Jft SUBJECT PRESCRIPTION CHANGES - OPTUM RX - EFFECTIVE JANUARY 12018
DATE FEBRUARY 6 2018
This notice is a follow-up to recent correspondence that you have received regarding your prescription coverage through the New Jersey State Health Benefits Program
Effective January 1 st 2018 OptumRX has been selected to be the pharmacy care services manager replacing Express Scripts your provider since April 1 st 2016
Enclosed is a copy of OptumRX s online account setup and directions on how to obtain supporting documentation through OptiumRX required for submitting prescription reimbursement claims
This change from Express Scripts to OptumRX does not change the reimbursement process currently in place However there are minor changes to the supporting documentation that is available through OptumRX that is different from the supporting documentation that was provided online through Express Scnipts
Please take time to review the enclosed OptumRX procedures and available supporting documentation (retail and mail-in) required when submitting prescription claims for purchases effective January 1 2018
Also take note that there is no change to the supporting documentation required for medical claims or supporting documentation you may receive when purchasing prescriptions through retail pharmacies
If you have any further questions or concerns please contact either Christine Scola or me at (856) 728-9800 ext 205 or 202 or through email cscolamonroetownshipnj org or kheydelmonroetownshipn j org
TOWNSHIP OF MONROE INSTRUCTIONS FOR SETTING UP ONLINE USER ACCOUNTS FOR
OPTUM MAIL ORDER PRESCRIPTION SERVICES AND FOR SUPPORTING DOCUMENTATION FOR
RETIREE PRESCRIPTION REIMBURSEMENT CLAIMS
These instructions will explain the procedure for on-line regi stration with your prescription provider OPTUM
The purpose of your registration is to provide you on-line access to your prescription information These online tools are necessary in order for you the retiree to gather the information and required documentation necessary to receive reim bursement for out-or-pocket expenses incurred for certain prescription ex pen se s that occurred on or after January 1 2018 (the date the New Jersey State Health Benefit Program switched prescription coverage from Express Scripts to OPTUM RX Pharmacy Care Services)
ILEASE NOTE A SEIERATE ONLINE ACCOUNT MUST BE SET UI FOR TilE RETIREE A ND DEPEiiDENT
OPTUM - PRESCRIPTION CLAfMS
Procedure for Setting up a User Account
1 Go to wwwOptum com
2 Click on Pharmacy Care Services
- I ___ --~ middot n _ 01111 lO U 1 _
OPTUM
f middot hfORHtHll LH l idU
through insight and II1novation
JU bull rei bull flU IH II tI
Everest Group recognizes Optum
3 On the OptumRx Pharmacy Care SelVices page - Click on Member Sign - In
lIIIM
nbullbull OPTUM
OptumRx pharmacy care services
00 0
Optum tackles challenges across the system
bull I II ra _ D fig - ~J
4 Register - Click on Register
YOUIt In control We r~ to he p
5 Follow Registration Instructions
lioJlt1 ll1OPTUM
TIlt ~I~ tonttImtlll In h Ip lII u(~1 he wl l of fO II
~S~hGl Ip tortrwtllCln
AtrdY1 bull iI Hhi lbSa f [0 cr OptLlITIIDl
f lrl I IUrn Nftd~l
f OIlQiI1JOII hbullbull plogtstUolI u IOJII lJi Fot h QUtlnO lt0 m- pit litho nurnlrogtt 0 he ~ _ 1011
AlI you a OptumRx C8IICi IJ1
Drulof bfrth YU~J WI bIt l1te to rOflfnm you C4N~h
iIlVllJI IOfI Il I(1nl ~ Ift ( P tOU I in ilihOIl
hltllly
OptumOx
YUH (Ji ll a((~pt tu~lf ) 1 hd~lt IMO1 trY-Ill aJ not ~ mtm~ oj OptUlflitlt tt ~ I1rtMlfllbeor 10 ourn Drtr 0 KceatlMJ ~OlJt tlfl carq- rrntOtTh nllu~ (lUi t hmnrf l in 1111- hn (1f l1lU1 ~PJliraquot [O( tl td
fand yovr tnvlLlllOn ~
6 Upon Completion of Registration Go to Sign in and enterUsername and Password
s1I~j r III to Optllll1Rx
bullbullbull 1
7 When on the My Medicine Cabinet page go to the top toolbar Click on Benefits and Claims and then click on Clnim History
- bull _ I bull _ n~-- ~
u ~ ltan 0CWTUM
--
l _1
bull
O p t um Rx Hom D Ive rymiddot J medl(al lo ngt
-8 Once on Claim History Click on Claim Detail (Do Not Submit Claim History for Reimbursment)
0 --shy - ---~ -r os ~ ~ --a- ftJI_~
Claim history
( urrInlfy Vlevlng 2 cla Im
~~----11 If
9 After Clicking on Claim Detail- print Claim Detail and Submit for Reimbursement
rr_IInt ~r _ n - --
OPTIJM - - -- - -------=- ------ shy
Please note for each prescription reimbursement the above claim details are required for reimbursement You may retrieve claim details for both retail purchases and mail in purchases from the above procedures
Ordr~ ~
Cl ai m Details
r d1f OHIO IS
ctm NJrmw t 30 149TSg2014
prJQ~ Qmiddot0C~J~ ~ I OOO I 9J3-2a ~
t( OOO ll B1UGS
~ul l 10000
~IoITtVf1W1I 1n1Mft11NHI1Ikf ~d v
av 8
QlT1tlnx YoQIIPMl SIJ25
WmTH~rlt)l PMlP-o Sl 68
OiIllANO PA~oltl(S Wll ~~11rt1UU middot SoaltI
fJ fIl(f unu Sooo 0 W q ~)
Looking for your benefit information)
Additionally when ordering directly through OPTUM RX mail in services upon receipt of your prescription you will also find an invoice which can also be used as supporting documentation for filing your reimbursement
O middot middot oL - 1 bullbullbullbullbull O bullbull middotmiddotmiddotlotmiddot V r r LI bullbullbullJ
lt~ bullbull bullbull bullbull-l V bullbull i ~( 4 bull
u I I I tgt1 t bullbull I Imiddot bull bull
r Al I II IU 1 -
In bullbull middot~ bullbull 1( 1 r- ) O - _ - - - plr~ CI oo 1 - v~ shy bullbull bull 1 j oo cI bull t bullbullbullbullbull_ II
A--oJ bullbull 1 _ 1
_ H _ bullbull bull It ~ I bull bull bull IIIIIlIII I bull middot bullbull
There lire no changes to retail (CVS Walgreens Rite Aid etc) You may still provide the receipts thlit you receive from your retail pharmacy as depicted in the example below
1111 I f IlhWl IJIIIIll1I1 nI
Sign up ncgtIV ~Cgt r tex-t a~rls
tL t l In 1 _111 I- your 1 (0 L r c-- Iyshy
Any questions regarding these procedures can be directed to either Christine J Scola at (856) 728 - 9800 ext 205 or Kevin W Heydel at (856) 728 - 9800 ext 202
TOWNSHIP OF MONROE INSTRUCTIONS FOR SETTING UP ONLINE USER ACCOUNTS FOR
OPTUM MAIL ORDER PRESCRIPTION SERVICES AND FOR SUPPORTING DOCUMENTATION FOR
RETIREE PRESCRIPTION REIMBURSEMENT CLAIMS
These instructions will explain the procedure for on-line regi stration with your prescription provider OPTUM
The purpose of your registration is to provide you on-line access to your prescription information These online tools are necessary in order for you the retiree to gather the information and required documentation necessary to receive reim bursement for out-or-pocket expenses incurred for certain prescription ex pen se s that occurred on or after January 1 2018 (the date the New Jersey State Health Benefit Program switched prescription coverage from Express Scripts to OPTUM RX Pharmacy Care Services)
ILEASE NOTE A SEIERATE ONLINE ACCOUNT MUST BE SET UI FOR TilE RETIREE A ND DEPEiiDENT
OPTUM - PRESCRIPTION CLAfMS
Procedure for Setting up a User Account
1 Go to wwwOptum com
2 Click on Pharmacy Care Services
- I ___ --~ middot n _ 01111 lO U 1 _
OPTUM
f middot hfORHtHll LH l idU
through insight and II1novation
JU bull rei bull flU IH II tI
Everest Group recognizes Optum
3 On the OptumRx Pharmacy Care SelVices page - Click on Member Sign - In
lIIIM
nbullbull OPTUM
OptumRx pharmacy care services
00 0
Optum tackles challenges across the system
bull I II ra _ D fig - ~J
4 Register - Click on Register
YOUIt In control We r~ to he p
5 Follow Registration Instructions
lioJlt1 ll1OPTUM
TIlt ~I~ tonttImtlll In h Ip lII u(~1 he wl l of fO II
~S~hGl Ip tortrwtllCln
AtrdY1 bull iI Hhi lbSa f [0 cr OptLlITIIDl
f lrl I IUrn Nftd~l
f OIlQiI1JOII hbullbull plogtstUolI u IOJII lJi Fot h QUtlnO lt0 m- pit litho nurnlrogtt 0 he ~ _ 1011
AlI you a OptumRx C8IICi IJ1
Drulof bfrth YU~J WI bIt l1te to rOflfnm you C4N~h
iIlVllJI IOfI Il I(1nl ~ Ift ( P tOU I in ilihOIl
hltllly
OptumOx
YUH (Ji ll a((~pt tu~lf ) 1 hd~lt IMO1 trY-Ill aJ not ~ mtm~ oj OptUlflitlt tt ~ I1rtMlfllbeor 10 ourn Drtr 0 KceatlMJ ~OlJt tlfl carq- rrntOtTh nllu~ (lUi t hmnrf l in 1111- hn (1f l1lU1 ~PJliraquot [O( tl td
fand yovr tnvlLlllOn ~
6 Upon Completion of Registration Go to Sign in and enterUsername and Password
s1I~j r III to Optllll1Rx
bullbullbull 1
7 When on the My Medicine Cabinet page go to the top toolbar Click on Benefits and Claims and then click on Clnim History
- bull _ I bull _ n~-- ~
u ~ ltan 0CWTUM
--
l _1
bull
O p t um Rx Hom D Ive rymiddot J medl(al lo ngt
-8 Once on Claim History Click on Claim Detail (Do Not Submit Claim History for Reimbursment)
0 --shy - ---~ -r os ~ ~ --a- ftJI_~
Claim history
( urrInlfy Vlevlng 2 cla Im
~~----11 If
9 After Clicking on Claim Detail- print Claim Detail and Submit for Reimbursement
rr_IInt ~r _ n - --
OPTIJM - - -- - -------=- ------ shy
Please note for each prescription reimbursement the above claim details are required for reimbursement You may retrieve claim details for both retail purchases and mail in purchases from the above procedures
Ordr~ ~
Cl ai m Details
r d1f OHIO IS
ctm NJrmw t 30 149TSg2014
prJQ~ Qmiddot0C~J~ ~ I OOO I 9J3-2a ~
t( OOO ll B1UGS
~ul l 10000
~IoITtVf1W1I 1n1Mft11NHI1Ikf ~d v
av 8
QlT1tlnx YoQIIPMl SIJ25
WmTH~rlt)l PMlP-o Sl 68
OiIllANO PA~oltl(S Wll ~~11rt1UU middot SoaltI
fJ fIl(f unu Sooo 0 W q ~)
Looking for your benefit information)
Additionally when ordering directly through OPTUM RX mail in services upon receipt of your prescription you will also find an invoice which can also be used as supporting documentation for filing your reimbursement
O middot middot oL - 1 bullbullbullbullbull O bullbull middotmiddotmiddotlotmiddot V r r LI bullbullbullJ
lt~ bullbull bullbull bullbull-l V bullbull i ~( 4 bull
u I I I tgt1 t bullbull I Imiddot bull bull
r Al I II IU 1 -
In bullbull middot~ bullbull 1( 1 r- ) O - _ - - - plr~ CI oo 1 - v~ shy bullbull bull 1 j oo cI bull t bullbullbullbullbull_ II
A--oJ bullbull 1 _ 1
_ H _ bullbull bull It ~ I bull bull bull IIIIIlIII I bull middot bullbull
There lire no changes to retail (CVS Walgreens Rite Aid etc) You may still provide the receipts thlit you receive from your retail pharmacy as depicted in the example below
1111 I f IlhWl IJIIIIll1I1 nI
Sign up ncgtIV ~Cgt r tex-t a~rls
tL t l In 1 _111 I- your 1 (0 L r c-- Iyshy
Any questions regarding these procedures can be directed to either Christine J Scola at (856) 728 - 9800 ext 205 or Kevin W Heydel at (856) 728 - 9800 ext 202
3 On the OptumRx Pharmacy Care SelVices page - Click on Member Sign - In
lIIIM
nbullbull OPTUM
OptumRx pharmacy care services
00 0
Optum tackles challenges across the system
bull I II ra _ D fig - ~J
4 Register - Click on Register
YOUIt In control We r~ to he p
5 Follow Registration Instructions
lioJlt1 ll1OPTUM
TIlt ~I~ tonttImtlll In h Ip lII u(~1 he wl l of fO II
~S~hGl Ip tortrwtllCln
AtrdY1 bull iI Hhi lbSa f [0 cr OptLlITIIDl
f lrl I IUrn Nftd~l
f OIlQiI1JOII hbullbull plogtstUolI u IOJII lJi Fot h QUtlnO lt0 m- pit litho nurnlrogtt 0 he ~ _ 1011
AlI you a OptumRx C8IICi IJ1
Drulof bfrth YU~J WI bIt l1te to rOflfnm you C4N~h
iIlVllJI IOfI Il I(1nl ~ Ift ( P tOU I in ilihOIl
hltllly
OptumOx
YUH (Ji ll a((~pt tu~lf ) 1 hd~lt IMO1 trY-Ill aJ not ~ mtm~ oj OptUlflitlt tt ~ I1rtMlfllbeor 10 ourn Drtr 0 KceatlMJ ~OlJt tlfl carq- rrntOtTh nllu~ (lUi t hmnrf l in 1111- hn (1f l1lU1 ~PJliraquot [O( tl td
fand yovr tnvlLlllOn ~
6 Upon Completion of Registration Go to Sign in and enterUsername and Password
s1I~j r III to Optllll1Rx
bullbullbull 1
7 When on the My Medicine Cabinet page go to the top toolbar Click on Benefits and Claims and then click on Clnim History
- bull _ I bull _ n~-- ~
u ~ ltan 0CWTUM
--
l _1
bull
O p t um Rx Hom D Ive rymiddot J medl(al lo ngt
-8 Once on Claim History Click on Claim Detail (Do Not Submit Claim History for Reimbursment)
0 --shy - ---~ -r os ~ ~ --a- ftJI_~
Claim history
( urrInlfy Vlevlng 2 cla Im
~~----11 If
9 After Clicking on Claim Detail- print Claim Detail and Submit for Reimbursement
rr_IInt ~r _ n - --
OPTIJM - - -- - -------=- ------ shy
Please note for each prescription reimbursement the above claim details are required for reimbursement You may retrieve claim details for both retail purchases and mail in purchases from the above procedures
Ordr~ ~
Cl ai m Details
r d1f OHIO IS
ctm NJrmw t 30 149TSg2014
prJQ~ Qmiddot0C~J~ ~ I OOO I 9J3-2a ~
t( OOO ll B1UGS
~ul l 10000
~IoITtVf1W1I 1n1Mft11NHI1Ikf ~d v
av 8
QlT1tlnx YoQIIPMl SIJ25
WmTH~rlt)l PMlP-o Sl 68
OiIllANO PA~oltl(S Wll ~~11rt1UU middot SoaltI
fJ fIl(f unu Sooo 0 W q ~)
Looking for your benefit information)
Additionally when ordering directly through OPTUM RX mail in services upon receipt of your prescription you will also find an invoice which can also be used as supporting documentation for filing your reimbursement
O middot middot oL - 1 bullbullbullbullbull O bullbull middotmiddotmiddotlotmiddot V r r LI bullbullbullJ
lt~ bullbull bullbull bullbull-l V bullbull i ~( 4 bull
u I I I tgt1 t bullbull I Imiddot bull bull
r Al I II IU 1 -
In bullbull middot~ bullbull 1( 1 r- ) O - _ - - - plr~ CI oo 1 - v~ shy bullbull bull 1 j oo cI bull t bullbullbullbullbull_ II
A--oJ bullbull 1 _ 1
_ H _ bullbull bull It ~ I bull bull bull IIIIIlIII I bull middot bullbull
There lire no changes to retail (CVS Walgreens Rite Aid etc) You may still provide the receipts thlit you receive from your retail pharmacy as depicted in the example below
1111 I f IlhWl IJIIIIll1I1 nI
Sign up ncgtIV ~Cgt r tex-t a~rls
tL t l In 1 _111 I- your 1 (0 L r c-- Iyshy
Any questions regarding these procedures can be directed to either Christine J Scola at (856) 728 - 9800 ext 205 or Kevin W Heydel at (856) 728 - 9800 ext 202
5 Follow Registration Instructions
lioJlt1 ll1OPTUM
TIlt ~I~ tonttImtlll In h Ip lII u(~1 he wl l of fO II
~S~hGl Ip tortrwtllCln
AtrdY1 bull iI Hhi lbSa f [0 cr OptLlITIIDl
f lrl I IUrn Nftd~l
f OIlQiI1JOII hbullbull plogtstUolI u IOJII lJi Fot h QUtlnO lt0 m- pit litho nurnlrogtt 0 he ~ _ 1011
AlI you a OptumRx C8IICi IJ1
Drulof bfrth YU~J WI bIt l1te to rOflfnm you C4N~h
iIlVllJI IOfI Il I(1nl ~ Ift ( P tOU I in ilihOIl
hltllly
OptumOx
YUH (Ji ll a((~pt tu~lf ) 1 hd~lt IMO1 trY-Ill aJ not ~ mtm~ oj OptUlflitlt tt ~ I1rtMlfllbeor 10 ourn Drtr 0 KceatlMJ ~OlJt tlfl carq- rrntOtTh nllu~ (lUi t hmnrf l in 1111- hn (1f l1lU1 ~PJliraquot [O( tl td
fand yovr tnvlLlllOn ~
6 Upon Completion of Registration Go to Sign in and enterUsername and Password
s1I~j r III to Optllll1Rx
bullbullbull 1
7 When on the My Medicine Cabinet page go to the top toolbar Click on Benefits and Claims and then click on Clnim History
- bull _ I bull _ n~-- ~
u ~ ltan 0CWTUM
--
l _1
bull
O p t um Rx Hom D Ive rymiddot J medl(al lo ngt
-8 Once on Claim History Click on Claim Detail (Do Not Submit Claim History for Reimbursment)
0 --shy - ---~ -r os ~ ~ --a- ftJI_~
Claim history
( urrInlfy Vlevlng 2 cla Im
~~----11 If
9 After Clicking on Claim Detail- print Claim Detail and Submit for Reimbursement
rr_IInt ~r _ n - --
OPTIJM - - -- - -------=- ------ shy
Please note for each prescription reimbursement the above claim details are required for reimbursement You may retrieve claim details for both retail purchases and mail in purchases from the above procedures
Ordr~ ~
Cl ai m Details
r d1f OHIO IS
ctm NJrmw t 30 149TSg2014
prJQ~ Qmiddot0C~J~ ~ I OOO I 9J3-2a ~
t( OOO ll B1UGS
~ul l 10000
~IoITtVf1W1I 1n1Mft11NHI1Ikf ~d v
av 8
QlT1tlnx YoQIIPMl SIJ25
WmTH~rlt)l PMlP-o Sl 68
OiIllANO PA~oltl(S Wll ~~11rt1UU middot SoaltI
fJ fIl(f unu Sooo 0 W q ~)
Looking for your benefit information)
Additionally when ordering directly through OPTUM RX mail in services upon receipt of your prescription you will also find an invoice which can also be used as supporting documentation for filing your reimbursement
O middot middot oL - 1 bullbullbullbullbull O bullbull middotmiddotmiddotlotmiddot V r r LI bullbullbullJ
lt~ bullbull bullbull bullbull-l V bullbull i ~( 4 bull
u I I I tgt1 t bullbull I Imiddot bull bull
r Al I II IU 1 -
In bullbull middot~ bullbull 1( 1 r- ) O - _ - - - plr~ CI oo 1 - v~ shy bullbull bull 1 j oo cI bull t bullbullbullbullbull_ II
A--oJ bullbull 1 _ 1
_ H _ bullbull bull It ~ I bull bull bull IIIIIlIII I bull middot bullbull
There lire no changes to retail (CVS Walgreens Rite Aid etc) You may still provide the receipts thlit you receive from your retail pharmacy as depicted in the example below
1111 I f IlhWl IJIIIIll1I1 nI
Sign up ncgtIV ~Cgt r tex-t a~rls
tL t l In 1 _111 I- your 1 (0 L r c-- Iyshy
Any questions regarding these procedures can be directed to either Christine J Scola at (856) 728 - 9800 ext 205 or Kevin W Heydel at (856) 728 - 9800 ext 202
7 When on the My Medicine Cabinet page go to the top toolbar Click on Benefits and Claims and then click on Clnim History
- bull _ I bull _ n~-- ~
u ~ ltan 0CWTUM
--
l _1
bull
O p t um Rx Hom D Ive rymiddot J medl(al lo ngt
-8 Once on Claim History Click on Claim Detail (Do Not Submit Claim History for Reimbursment)
0 --shy - ---~ -r os ~ ~ --a- ftJI_~
Claim history
( urrInlfy Vlevlng 2 cla Im
~~----11 If
9 After Clicking on Claim Detail- print Claim Detail and Submit for Reimbursement
rr_IInt ~r _ n - --
OPTIJM - - -- - -------=- ------ shy
Please note for each prescription reimbursement the above claim details are required for reimbursement You may retrieve claim details for both retail purchases and mail in purchases from the above procedures
Ordr~ ~
Cl ai m Details
r d1f OHIO IS
ctm NJrmw t 30 149TSg2014
prJQ~ Qmiddot0C~J~ ~ I OOO I 9J3-2a ~
t( OOO ll B1UGS
~ul l 10000
~IoITtVf1W1I 1n1Mft11NHI1Ikf ~d v
av 8
QlT1tlnx YoQIIPMl SIJ25
WmTH~rlt)l PMlP-o Sl 68
OiIllANO PA~oltl(S Wll ~~11rt1UU middot SoaltI
fJ fIl(f unu Sooo 0 W q ~)
Looking for your benefit information)
Additionally when ordering directly through OPTUM RX mail in services upon receipt of your prescription you will also find an invoice which can also be used as supporting documentation for filing your reimbursement
O middot middot oL - 1 bullbullbullbullbull O bullbull middotmiddotmiddotlotmiddot V r r LI bullbullbullJ
lt~ bullbull bullbull bullbull-l V bullbull i ~( 4 bull
u I I I tgt1 t bullbull I Imiddot bull bull
r Al I II IU 1 -
In bullbull middot~ bullbull 1( 1 r- ) O - _ - - - plr~ CI oo 1 - v~ shy bullbull bull 1 j oo cI bull t bullbullbullbullbull_ II
A--oJ bullbull 1 _ 1
_ H _ bullbull bull It ~ I bull bull bull IIIIIlIII I bull middot bullbull
There lire no changes to retail (CVS Walgreens Rite Aid etc) You may still provide the receipts thlit you receive from your retail pharmacy as depicted in the example below
1111 I f IlhWl IJIIIIll1I1 nI
Sign up ncgtIV ~Cgt r tex-t a~rls
tL t l In 1 _111 I- your 1 (0 L r c-- Iyshy
Any questions regarding these procedures can be directed to either Christine J Scola at (856) 728 - 9800 ext 205 or Kevin W Heydel at (856) 728 - 9800 ext 202
9 After Clicking on Claim Detail- print Claim Detail and Submit for Reimbursement
rr_IInt ~r _ n - --
OPTIJM - - -- - -------=- ------ shy
Please note for each prescription reimbursement the above claim details are required for reimbursement You may retrieve claim details for both retail purchases and mail in purchases from the above procedures
Ordr~ ~
Cl ai m Details
r d1f OHIO IS
ctm NJrmw t 30 149TSg2014
prJQ~ Qmiddot0C~J~ ~ I OOO I 9J3-2a ~
t( OOO ll B1UGS
~ul l 10000
~IoITtVf1W1I 1n1Mft11NHI1Ikf ~d v
av 8
QlT1tlnx YoQIIPMl SIJ25
WmTH~rlt)l PMlP-o Sl 68
OiIllANO PA~oltl(S Wll ~~11rt1UU middot SoaltI
fJ fIl(f unu Sooo 0 W q ~)
Looking for your benefit information)
Additionally when ordering directly through OPTUM RX mail in services upon receipt of your prescription you will also find an invoice which can also be used as supporting documentation for filing your reimbursement
O middot middot oL - 1 bullbullbullbullbull O bullbull middotmiddotmiddotlotmiddot V r r LI bullbullbullJ
lt~ bullbull bullbull bullbull-l V bullbull i ~( 4 bull
u I I I tgt1 t bullbull I Imiddot bull bull
r Al I II IU 1 -
In bullbull middot~ bullbull 1( 1 r- ) O - _ - - - plr~ CI oo 1 - v~ shy bullbull bull 1 j oo cI bull t bullbullbullbullbull_ II
A--oJ bullbull 1 _ 1
_ H _ bullbull bull It ~ I bull bull bull IIIIIlIII I bull middot bullbull
There lire no changes to retail (CVS Walgreens Rite Aid etc) You may still provide the receipts thlit you receive from your retail pharmacy as depicted in the example below
1111 I f IlhWl IJIIIIll1I1 nI
Sign up ncgtIV ~Cgt r tex-t a~rls
tL t l In 1 _111 I- your 1 (0 L r c-- Iyshy
Any questions regarding these procedures can be directed to either Christine J Scola at (856) 728 - 9800 ext 205 or Kevin W Heydel at (856) 728 - 9800 ext 202
Additionally when ordering directly through OPTUM RX mail in services upon receipt of your prescription you will also find an invoice which can also be used as supporting documentation for filing your reimbursement
O middot middot oL - 1 bullbullbullbullbull O bullbull middotmiddotmiddotlotmiddot V r r LI bullbullbullJ
lt~ bullbull bullbull bullbull-l V bullbull i ~( 4 bull
u I I I tgt1 t bullbull I Imiddot bull bull
r Al I II IU 1 -
In bullbull middot~ bullbull 1( 1 r- ) O - _ - - - plr~ CI oo 1 - v~ shy bullbull bull 1 j oo cI bull t bullbullbullbullbull_ II
A--oJ bullbull 1 _ 1
_ H _ bullbull bull It ~ I bull bull bull IIIIIlIII I bull middot bullbull
There lire no changes to retail (CVS Walgreens Rite Aid etc) You may still provide the receipts thlit you receive from your retail pharmacy as depicted in the example below
1111 I f IlhWl IJIIIIll1I1 nI
Sign up ncgtIV ~Cgt r tex-t a~rls
tL t l In 1 _111 I- your 1 (0 L r c-- Iyshy
Any questions regarding these procedures can be directed to either Christine J Scola at (856) 728 - 9800 ext 205 or Kevin W Heydel at (856) 728 - 9800 ext 202
