The following is directly from ADOT...
Sections of Interstate 17 in north Phoenix are scheduled to be closed this weekend (weather permitting) while crews add new lane stripes to the freeway. Drivers are encouraged to use alternate routes to avoid traffic backups while the following restrictions are in place:
* Southbound I-17 will be closed between Bell Road and Peoria Avenue from 7 a.m. to 7 p.m. Saturday (Jan. 14) while crews add "permanent" lane stripes along the recently widened section of the freeway. Southbound I-17 traffic can exit at Bell Road and use southbound 19th or 35th avenues as alternate southbound routes to travel beyond the closure. Drivers also should consider exiting onto the eastbound Loop 101 to southbound State Route 51 (Piestewa Freeway) as an alternate freeway route to reach the downtown Phoenix area. Crews have worked in the past year to add new merge lanes, sound walls and other improvements to I-17 between Peoria and Bell.
* Northbound I-17 will be closed between Peoria Avenue and Bell Road from 7 a.m. to 7 p.m. Sunday (Jan. 15) while crews complete work add new lane stripes to the freeway. Northbound I-17 traffic will need to exit at Peoria Avenue and use 19th or 35th avenues as alternate northbound routes in the area. Drivers are encouraged to exit the freeway well ahead of the closure in order to avoid traffic backups. Drivers should also consider using northbound State Route 51 to westbound Loop 101 in north Phoenix as an alternate route to reach I-17 beyond the closure.
Thursday, January 12, 2006
Saturday, January 07, 2006
What your Pharmacist Needs to Know to Fill Your 2006 Medicare Prescription
Quick Answers to FAQs on Processing Claims for Dual Eligible Beneficiaries
(From CMS... the agency rolling out the new drug plan)
• What if a dual eligible beneficiary (Medicare and Medicaid) presents at the pharmacy and does not know what plan he or she has been auto enrolled in?
The pharmacist should send an E1 query to determine Part D plan enrollment. If the E1 query returns the RxBIN-RxPCN-RXGrp-RxID (the "4Rx" data) and 800 number of a Part D plan, the pharmacist should bill the plan. If the E1 query returns just the 800 number of the plan, the pharmacist should call the 800 number to obtain the billing information from the plan. If the E1 query returns no match, the pharmacist should check for Medicare eligibility by submitting an expanded E1 query and Medicaid eligibility through the patient history, a Medicaid card, or a current Medicaid letter. Pharmacists can also call a dedicated pharmacy eligibility line at 1-866-835-7595. The pharmacist may use the Point of Sale facilitated enrollment solution once dual eligibility is determined.
• What if a dual eligible beneficiary who has been auto enrolled presents at a pharmacy with a plan acknowledgement letter indicating that the beneficiary has switched plans?
If the person does have their plan acknowledgement letter in hand, that letter should include the RxBin, RxPCN, RxGrp and RxID, generally in the upper left hand area above the greeting. The pharmacist should use that information for billing or, if the letter does not include this information, the pharmacy should call the plan to get the information needed to send in a claim.
• What if a dual eligible beneficiary who has been auto enrolled presents at a pharmacy without a plan acknowledgement letter, but indicates that he or she has switched plans?
The pharmacist should send an E1 query or call a dedicated pharmacy eligibility line at 1-866-835-7595 to determine Part D plan enrollment (or 1-800-MEDICARE between 8 PM and 8 AM ET).
• What if a beneficiary presents at a pharmacy with a Medicaid card and appears to be Medicare eligible, but the pharmacist cannot determine that the beneficiary has been auto-enrolled in any plan?
Once the E1 query has failed and the pharmacist has reasonable basis for believing the beneficiary is dually eligible, the POS Contractor (Anthem) should be billed. This will allow for the prescription to be filled and begin the process of enrolling the dual eligible beneficiary into a Part D plan.
Please see “What If Scenarios for Pharmacy” for a more detailed list of FAQs.
(From CMS... the agency rolling out the new drug plan)
• What if a dual eligible beneficiary (Medicare and Medicaid) presents at the pharmacy and does not know what plan he or she has been auto enrolled in?
The pharmacist should send an E1 query to determine Part D plan enrollment. If the E1 query returns the RxBIN-RxPCN-RXGrp-RxID (the "4Rx" data) and 800 number of a Part D plan, the pharmacist should bill the plan. If the E1 query returns just the 800 number of the plan, the pharmacist should call the 800 number to obtain the billing information from the plan. If the E1 query returns no match, the pharmacist should check for Medicare eligibility by submitting an expanded E1 query and Medicaid eligibility through the patient history, a Medicaid card, or a current Medicaid letter. Pharmacists can also call a dedicated pharmacy eligibility line at 1-866-835-7595. The pharmacist may use the Point of Sale facilitated enrollment solution once dual eligibility is determined.
• What if a dual eligible beneficiary who has been auto enrolled presents at a pharmacy with a plan acknowledgement letter indicating that the beneficiary has switched plans?
If the person does have their plan acknowledgement letter in hand, that letter should include the RxBin, RxPCN, RxGrp and RxID, generally in the upper left hand area above the greeting. The pharmacist should use that information for billing or, if the letter does not include this information, the pharmacy should call the plan to get the information needed to send in a claim.
• What if a dual eligible beneficiary who has been auto enrolled presents at a pharmacy without a plan acknowledgement letter, but indicates that he or she has switched plans?
The pharmacist should send an E1 query or call a dedicated pharmacy eligibility line at 1-866-835-7595 to determine Part D plan enrollment (or 1-800-MEDICARE between 8 PM and 8 AM ET).
• What if a beneficiary presents at a pharmacy with a Medicaid card and appears to be Medicare eligible, but the pharmacist cannot determine that the beneficiary has been auto-enrolled in any plan?
Once the E1 query has failed and the pharmacist has reasonable basis for believing the beneficiary is dually eligible, the POS Contractor (Anthem) should be billed. This will allow for the prescription to be filled and begin the process of enrolling the dual eligible beneficiary into a Part D plan.
Please see “What If Scenarios for Pharmacy” for a more detailed list of FAQs.
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