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Currently, there are three regional Managed Care Support Contractors, a Medicare/Tricare Dual Eligible Fiscal Intermediary Contractor, and a Tricare Pharmacy contractor, who administers both Mail Order Pharmacy and Retail Pharmacy programs. In addition several administrative contractors provide quality management, auditing, and statistical ...
One of its largest clients is the United States Department of Defense's Tricare program. [4] Express Scripts also offers pharmacy benefit management services for workers' compensation insurance programs. The program is accredited by URAC, the nation's largest accrediting body for pharmacy benefit management companies.
The maximum turnaround time is 48 hours from the time an order is transmitted from a centralized database in Arizona and a prescription arrives at its final destination on average 2.2 days after it gets into the mail stream. [3] The North Charleston, Dallas, Hines, and Tucson CMOPs operate on two shifts per day.
Medco's mail-order business generated $26 billion in 2011 net revenues and was one of the largest pharmacy operations in the United States. In 2011, 113 million of the 757.7 million prescriptions Medco filled were processed through its mail-order pharmacies. In 2011, nearly 10.5 million of the new prescriptions Medco managed were ePrescriptions.
They were awarded their first TRICARE contract in 1995, and began serving military beneficiaries in 1996. [32] From 2004 to 2009, HMHS was the managed care contractor for the Department of Defense Military Health System TRICARE South Region.
CHCS is module based: modules include RAD (radiology), LAB (Laboratory), PHR (Pharmacy), PAS (Patient Appointing & Scheduling), MCP (Managed Care Program; used to support TRICARE enrollees by enrolling them to Primary Care Managers), PAD (Patient Administration): MRT (Medical Records Tracking), MSA (Medical Service Accounting) medical billing, WAM (Workload Assignment Module), DTS (Dietetics ...