Medicare Part D Claims Switching Services

The contractor will provide switch services to connect software installed at each HHSC Facility Pharmacy with residents' respective Prescription Drug Plans (PDP) to submit claims for prescription drugs provided to residents eligible for Medicare Part D for reimbursement. Services include switch services per claim, reclaim/pre and post editing per claim, commercial card finder eligibility search per search, Medicare D eligibility search per search, Medicare D mapping service per search, Average Wholesale Price (AWP) resubmission monthly fee per enrolled location, and Prescriber Schedule Authority monthly fee per enrolled location. Services shall be performed online, Monday through Friday between 8 a.m. and 5 p.m. Central Time, with a four-hour response time to service calls.