Frequently
Asked Questions
Q:
Whom do I contact for benefits if I am no longer with your
company?
A.
You can contact your plan administrator, human resources or
benefit department through your employer, broker, etc.
Q.
Who do I contact to change my DOB, name, address, etc.
A.
You may contact your plan administrator, human resources or
benefit department through your employer, or broker.
Q.
Who do I contact to cancel benefits?
A.
You may contact your plan administrator, human resources or
benefit department through your employer, or broker.
Q.
What pharmacies in my area will accept CBCA Rx benefit cards?
A.
Most major pharmacy chains, such as Rite Aid, Walgreens, and
Eckerds, accept CBCA Rx cards. Independent pharmacies may
also be contracted with CBCA Rx and this is done on an as
needed basis by contacting CBCA Rx toll free at 800-383-8737.
Q.
How do I know whether or not my prescription is on the preferred
drug list?
A.
The preferred drug list can
be accessed at www.cbca.com or by contacting CBCA Rx Customer
Service Department toll free at 800-383-8737.
Q.
My pharmacy could not process my prescription and I now have
an out-of-pocket expense. What can I do?
A.
CBCA Rx Customer Service can contact the dispensing pharmacy
and assist them in processing the rejected claim, if possible,
and the pharmacy can reimburse you the difference of the price
you paid and your copay amount. If this is not possible, the
Customer Service Representative can research to see if the
client allows their members to submit prescriptions directly
to CBCA Rx for reimbursement. If allowed, the member is instructed
to mail to CBCA Rx their prescription detailed printout along
with their paid receipt for processing of a reimbursement
check.
Q.
I have submitted a reimbursement form for prescriptions I
paid out-of-pocket. How soon can I expect to receive my reimbursment
check?
A.
Once CBCA Rx receives your reimbursement form and necessary
accompanying documentation, it will be reviewed for processing.
If your reimbursement request is denied, a “rejection
letter” will be mailed to you explaining the reason
for denial. Examples of denials are, but not limited to, “your
benefit plan does not allow for reimbursement”, “this
drug is not covered under your plan”, “claim is
too old”, etc. In most cases, you can expect to receive
some form of correspondence (payment or denial) within two
weeks from the time we receive your request.
Q.
What is my prescription copayment?
A.
Your copayment will depend upon the group you have your benefits
through. CBCA Rx Customer Service Representative can look
up your coverage by obtaining some basic information such
as your cardholder ID#. In the case where the copay structure
is a “percentage”, our CBCA Rx Customer Service
Representative can provide you with an estimated cost for
your medication.
Q.
What is the days supply I am able to receive through mail
order?
A.
For most groups, it will be 90 days. CBCA Rx Customer Service
Representative can look up your coverage by obtaining some
basic information such as your cardholder ID#.
Q.
Do I really save money by ordering my prescriptions through
mail order?
A.
Absolutely; in most instances, by utilizing the mail order
component of your benefit plan, you will receive a 90-days
supply for the cost of a 60-days supply. Again, depending
upon your benefit plan, additional savings can be realized
because the copay amounts at the mail order level are less
than those at retail. To find out more, we can look up your
membership in our system to see the details of your plan’s
benefits. Or, you can contact your plan administrator, human
resources or benefit department for additional information.
Q.
What is my ID number?
A.
Your ID number is listed as your Member ID #. It is usually
located near your group number on the left-hand side of your
membership card.
Q.
How long will it take to receive my mail order prescription(s)?
A.
You can expect to receive your order approximately two weeks
from the time you mailed it in to the pharmacy.
Q.
I haven’t received my membership card yet.
A.
It takes approximately 10 days from the time we order a card
for you to receive it. We can look in our system to check
the date a card was requested.
Q.
I am a pharmacy trying to fill a prescription for one of your
members and it is rejecting for “Pharmacy not contracted
with plan on fill date”. How can I get a contract to
participate in your network?
A.
A pharmacy contract will be mailed to you for completion.
In the interim, we can set you up in our system temporarily
for 30 days as a pharmacy provider. This will enable you to
process claims for our members. Once we receive the completed,
signed contract, we will then activate your pharmacy in our
network.
Q.
How can I get a larger quantity prescription. My pharmacist
tells me that I can only have a certain number days supply,
but that amount is not enough for me.
A.
Your physician will need to fax or mail us a letter stating
your condition and the reason for the plan limitation increase.
Our Clinical Pharmacist will review the physician’s
request and consult with the plan’s Account Manager.
If approved, a plan exception will be added your member profile
in our system to allow this increase.
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