Pharmacy Benefit Management

Program Overview

Workforce Safety & Insurance (WSI) has contracted with US Script − a national pharmacy benefit management company − to handle the processing of our pharmacy charges. Our partnership with US Script will allow WSI to continue providing North Dakota's injured workers with their pharmacy benefits while providing a more efficient process for the pharmacies.

US Script

US Script offers a flexible plan design that has allowed WSI to incorporate many industry standards as well as provide for the unique requirements workers' compensation deals with. US Script has developed its claims adjudication software internally and is independent from any affiliations with drug companies or pharmacy chains. It is one of the few companies that offer the use of ICD−9 coding to identify appropriate medications for the injury.

Payments will be going to the pharmacies from US Script on a bi-weekly basis.

US Script offers a support staff through their call center. The call center is open 8 a.m. to 8 p.m., Monday through Friday and on Saturday from 9 a.m. to 4 p.m. Central Standard Time.

For additional information, please contact US Script at 1−800−460−8988 or access their web site at: https://www.usscript.com.

Plan Information

• Days Supply limits
  • Days Supply will be limited to 34 for acute use medications and 60 for chronic medications
• Drug Quantity Limits
• The Drug/Product Restriction lists all medications that are generally excluded from coverage. Prior authorization is required.
• Charges for Durable Medical Equipment (DME) or supply items (i.e. gauze, tape etc.) will still need to be submitted to WSI in paper format or electronically in the HCFA 1500 format.
• The Service Guide for Pharmacists outlines when to call US Script and when to call WSI.
• For a list of participating pharmacies, visit https://www.usscript.com/Script/PhLocator/zipInput.jsp

Plan Benefits

• Point-of-sale claims adjudication
• Readily accessible nationwide pharmacy network
• Drug utilization reviews to ensure safe prescription use
• Step therapy to ensure appropriate use of drugs and other therapies
• Prior authorizations that can be designed to be time dependent, drug dependent, patient dependent or physician dependent
• More efficient and effective patient care
• First Fill Program

First Fill Program

• Pharmacies will be guaranteed payment for the initial prescriptions of 7 days, not to exceed a total of $100.
• Charges may be submitted without a claim number, but will require the following information:
  • Patient Name (First and Last)
  • Date of Birth
  • SSN
  • Date of Injury
  • Employer Name
• Date of injury must be within 30 days of the date of billing.
• The First Fill Product Exclusion lists medications not covered in the program.
• Injured workers will qualify for the First Fill program once every six months.
• Injured workers with claim numbers do not qualify for the First Fill program. Those charges will be processed by the on-line adjudication system.

Contact Information