First Fill Prescription Benefits For Ohio’s Injured Workers
Posted: September 18, 2014
For 17 years CareWorks has been partnering with employers, healthcare providers and BWC to deliver high quality medical management and return to work services to our customers and their injured employees.
CareWorks’ services are designed to help employers minimize the financial impact of workers’ compensation injuries and help injured employees return to work and restore healthy, productive lifestyles as quickly and safely as possible.
Immediately following an injury, when an employee may be at the peak of their pain and discomfort, BWC ensures they can receive appropriate prescription benefits without paying any out-of-pocket expenses for their needed medication.
For the last several years, BWC has encouraged pharmacies to accept claims “on assignment.” This means the pharmacy will fill the needed medication for the injured worker without a claim number and at no charge to the injured worker. Once the claim becomes allowed, BWC’s pharmacy benefit manager (PBM) will pay the pharmacy.
In situations such as this, the pharmacy does get an additional dispensing fee for their flexibility. This program is not limited to one pharmacy. Any pharmacy, from a large national chain to a small local pharmacy, can agree to this process.
In some cases, the pharmacy will not agree to take a claim on assignment. Rather, they will charge the injured worker the amount the PBM would pay for the prescription. In these instances, as long as the pharmacy files the information with the PBM, the injured worker will be reimbursed by the pharmacy once the claim is allowed. If the claim is disallowed, the cost of the prescription will become the responsibility of the injured worker.
According to BWC, the top four pharmacies that will generally accept claims on assignment are CVS, Walgreens, Kroger and Rite Aid. It is always a good idea to check with your local pharmacy, even if one of those mentioned, to ensure they will accept a claim on a first fill basis.
CareWorks will continue to share with our customers any announcements, programs or services regarding Ohio workers’ compensation.
Thank you for your support of CareWorks!
Thank you for continuing to support CareWorks as your Ohio workers’ compensation managed care organization (MCO). Your feedback and ideas have helped us create a special company founded on exceptional customer service. Please call us toll-free, at 1-888-627-7586 if you ever have any questions about our services.