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New Pharmacy Vendor for Injured Workers

AMRRP has recently partnered with Healthesystems to provide pharmacy benefits to our workers’ compensation Members. Healthesystems will be our pharmacy network vendor for both retail and mail order pharmacy.

Beginning Tuesday, October 28, 2014, please provide the First Fill form (you can download this form by clicking the "COVERAGES" tab on the Home Page, then click "Work Comp" and find the link at the bottom of the page) to your newly injured worker to give to the pharmacist for processing first-time prescriptions. This form can be used at facilities with an on-site nurse or HR person and we have found that the use of this form greatly enhances the First Fill process.

Workers with existing claims who received pharmacy cards from Express Scripts or PMSI will transition automatically, and should have already received new pharmacy cards in the mail.

Prescriptions previously filled through Express Scripts and PMSI will be paid until 11/11/14. After that date, all prescriptions must be filled through Healthesystems.

The Healthesystems retail pharmacy network allows your injured workers to have their work-related medications filled at a local pharmacy with no out-of-pocket expense and at a discounted rate below fee schedule.

As we strive to increase our utilization of Healthesystems to include initial prescriptions, we have implemented a “First Fill” program. The First Fill program yields the following benefits:
  • No out-of-pocket expenses for your injured worker
  • Minimize out-of-network pharmacies
  • Ensures the policyholder network savings on the first fill and future prescriptions

    Dispensing of medications for a new injury frequently takes place within hours after the injury occurs and before the First Notice of Injury/101 Form has been fully processed. In these situations, Healthesystems will allow the pharmacy to provide a ten (10) day supply to the injured worker.

    The First Fill program provides us with the ability to electronically capture, process, and adjudicate an injured worker's first prescription drug claim. If we never receive the notice of loss or we deem the claim non-compensable, Healthesystems is at risk for the cost of the ten (10) day supply.

    If you have any questions regarding the First Fill process, please contact AMRRP Workers’ Compensation Supervisor Anthony Acosta at (602) 368-6606 or [email protected]

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