Processing of Claims
Southern Scripts will process all prescription claims. Claims will be processed online in a secure, cost-effective, and accurate manner. Within seconds, claims will be processed to confirm the individual’s eligibility, drug coverage, pricing, and detect any potential drug safety concerns. This instantaneous service relieves your staff of time-consuming navigation through complex pharmacy pricing.
We will make every effort to guarantee that no pharmacy (mail or retail) is being reimbursed on any National Drug Code (NDC) other than the original Manufacture’s NDC. Southern Scripts will make every effort to prospectively deny claims for “repackaged” NDCs to confirm that fair pharmacy pricing is being used at every angle.
Because achieving a high utilization rate of generics is essential to positively impacting a plan’s overall prescription costs, Southern Scripts maintains a Mandatory Generic Policy. Our Mandatory Generic Policy guarantees that the lowest cost for medications are being utilized to aim for an improved bottom line.
Optional High Dollar Claim Review
Southern Scripts will work to guarantee your prescription benefit resources are closely monitored. If this service is desired by your facility, any claim equal or greater than the designated dollar amount will require a Prior Authorization. Once a Prior Authorization is completed on an initial fill, additional refills will not require Prior Authorization for a designated time period of up to twelve months. We feel this is an essential feature for ensuring sound prescription management and will never charge an additional fee for Prior Authorizations.
We provide monthly, historical, and customized reporting to provide you with concrete data about your pharmacy financial information. Southern Scripts will validate all payments between the pharmacy vendor and your correctional facility throughout the life of the current contract. This includes a review of both ongoing monthly and historical data. We perform a monthly reporting to validate the accuracy of the information received from the pharmacy vendor on a monthly basis. Southern Scripts will conduct a historical report of the prescription detail records, prescription costs, billing files, and more for the life of the current contract to validate that our client has received all monies earned. We utilize proprietary and internally developed software to create customized reporting.
Southern Scripts Pharmacy Network is an extensive national network of retail pharmacies and includes all major chain pharmacies. Any willing pharmacy provider can participate and access our claims processing system. Your correctional facility can use any pharmacy that is preferred.