New Claims System Update

Provider Manual
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20 PRESCRIPTION DRUG COVERAGE

20.10 Transition Policy

New members in plans may be taking drugs that are not on the formulary or that are subject to certain restrictions, such as precertification or step-therapy. Current members may also be affected by changes in the formulary from one year to the next.

Please refer to the Amerigroup Provider Manual on their website at https://providers.Amerigroup.com for the most current information regarding Transition Policy.

Please note the IntegraNet transition policy applies only to those prescription drugs that are Part D drugs.