Pharmacy Provider Procedure Manual

• P-1. Introduction
• P-2. Contact Information
  • P-2.1. Vendor Drug Program
    • Clinician-administered Drug Administration
    • Drug Pricing
    • Eligibility Verification Portal
    • Pharmacy Claim Processing
    • Pharmacy Enrollment and Support
    • Third-party Recovery
    • Pharmacy Payment File Portal
    • Pharmacy Prior Authorization
    • Pharmacy Refunds
    • Fraud, Waste and Abuse Reporting
  • P-2.2. Managed Care
  • P-2.3. Children with Special Health Care Needs Services Program
  • P-2.4. Kidney Health Care Program
  • P-2.5. Medicare
  • P-2.6. Texas Health and Human Services
  • P-2.7. Texas Medicaid and Healthcare Partnership
  • P-2.8. DSHS Immunization Program
  • P-2.9. Centers for Medicare and Medicaid Services
• P-3. Enrollment
• P-4. Managed Care
• P-5. System Requirements
• P-6. Eligibility
• P-7. Coordination of Benefits
• P-8. Drug Policy
• P-9. Home Health Supplies
• P-10. Vitamins and Minerals
• P-11. Mosquito Repellent
• P-12. Drug Utilization Review
• P-13. Prior Authorization
• P-14. Pricing and Reimbursement
• P-15. 340B Resources
• P-16. Payment
• P-17. Audits
• P-18. Drug Rebates
• P-19. Documents
• P-20. Forms