the pharmacy is delivering the correct drug (including strength, amount, and form) and, if necessary, allow you to cancel or delay the order before you are billed and it is shipped. It is important that you respond each time you are contacted by the pharmacy, to let them know what to do with the new prescription and to prevent any delays in shipping. To opt out of automatic deliveries of new prescriptions received directly from your health care office, please contact us by calling <PBM provider’s Name > For certain kinds of drugs, you can use the Plan Benefits Warning: If member is running plan’s network mail-order program. In most cases, the (Complaining low or out of medication, ensure Mail Order (General) drugs provided through mail order are drugs that you about the to address and recommend take on a regular basis, for a chronic or long-term benefit) or visiting a retail pharmacy to get medical condition. The drugs that are not available Customer medication through the mail-order service are marked with plan’s Service a <"NM"> in our Drug List (Formulary). There are (Complaining reasons that we send them through mail order, can’t about the like state or federal laws. program) Our mail-order service allows you to order up plan’s
the pharmacy is delivering the correct drug (including strength, amount, and form) and, if necessary, allow you to cancel or delay the order before you are billed and it is shipped. It is important that you respond each time you are contacted by the pharmacy, to let them know what to do with the new prescription and to prevent any delays in shipping. To opt out of automatic deliveries of new prescriptions received directly from your health care provider’s office, please contact us by calling <PBM Name > Mail Order (General) For certain kinds of drugs, you can use the plan’s network mail-order program. In most cases, the drugs provided through mail order are drugs that you take on a regular basis, for a chronic or long-term medical condition. The drugs that are not available through the plan’s mail-order service are marked with a <"NM"> in our Drug List (Formulary). There are reasons that we can’t send them through mail order, like state or federal laws. Our plan’s mail-order service allows you to order up Plan Benefits (Complaining about the benefit) or Customer Service (Complaining about the program) Warning: If member is running low or out of medication, ensure to address and recommend visiting a retail pharmacy to get medication
ICE_AG_Grievance_Resolution_Matrix___Final(1).docx