Pharmacy staff can use one of the two VDP eligibility tools to verify the client’s enrollment in managed care. This includes the following:

Pharmacy staff can also contact the TMHP Provider Line to find enrollment status and the name of the MCO for clients enrolled in Medicaid or CHIP. Select Option 2 (Provider Inquiries), then Option 1 (Client Eligibility), and then follow the prompts to find enrollment status and the name of the person's MCO. Upon confirmation, pharmacy staff should contact the MCO.

Refer to the Pharmacy MCO Assistance Chart for contact information and claims routing information including BIN, PCN, and Group ID for each MCO.