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11:41:53 PM CDT
Tuesday, April 15, 2014

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Pharmacy Benefit Management

Topics First Fill Program Forms & Publications Service Guide for Pharmacists
Pharmacy Overview Sign Up Process Prior Authorization Form (M3) Quick Reference Sheet
US Script Pharmacy Fee Schedule Formulary/Product Resrictions Brand Medication Prior Authorization Form (P2)
Plan Benefits Generic Dispensing Drug Quantity Limits Relistor Prior Authorization Form (P3)
Plan Design First Fill Product Restrictions DAW1 Policy Statement
    Sample Narcotic Contract  

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

Robert Bagdasarian RPh. and Glenn Merrits, CPA formed US Script in 1999. Both have more than 20 years experience in Managed Care and pharmacy benefit management.

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

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

The First Fill Program is a program designed to allow the pharmacy to provide medication immediately to the injured worker in the event of an injury. This program will allow prescribed medications to be dispensed in a timely manner, while ensuring payment for the pharmacy. This benefit will take the cooperation of the pharmacy providers and the success of the program depends on help from the pharmacy community. Under this 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

Harvey Hanel PharmD
Pharmacy Benefit Specialist
Workforce Safety & Insurance
1−800−440−3796 (87222#)
1−701−328−7222
Fax 1−701−328−3793
hhanel@nd.gov
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