[
Throughout 2015 and 2016, AmeriHealth has been updating various aspects of
our Direct Ship Drug Program. This program is a value-added service that allows
our network providers to order select office-based drugs covered under the
medical benefit without incurring cost. AmeriHealth works directly with our
vendors to handle processing, payment, and delivery.
As previously communicated, Walgreens and PerformSpecialty are the preferred
vendors for the Direct Ship Drug Program as of March 1, 2016. All requests for
direct ship drugs are now fulfilled by these vendors, with the exception of
Synagis®, which continues to be fulfilled by ACRO Pharmaceutical
Services.
Submitting a new request
Providers who have been receiving direct ship drugs from other vendors need
to submit a new request to AmeriHealth. Once the new request is approved by
AmeriHealth, the provider will be notified and AmeriHealth will forward the
request to a preferred vendor for fulfillment. Providers should not contact the
vendors to order a drug through the Direct Ship Drug Program. The only
exception to this rule is for providers who request Synagis®;
those requests should go directly to ACRO Pharmaceutical Services.
Request forms are available on our Direct Ship Drug Program webpages for
AmeriHealth New Jersey and
for
AmeriHealth Pennsylvania. These forms were
recently updated with ICD-10 coding requirements, a new fax number, and, in
some cases, new coverage questions. Providers should always download direct
ship request forms from this page to ensure they are using the most up-to-date
versions. These webpages also provide more information on the program and the
list of medical benefit drugs available through direct ship.
Note: Precertification requirements may apply to drugs available
through the Direct Ship Drug Program, in accordance with the terms of
AmeriHealth medical policies. Member cost-sharing may also apply to select
drugs available through this program, based on the terms of the member?s
benefit contract. ]