What groups are impacted by this change?

BlueCross BlueShield of South Carolina and BlueChoice HealthPlan fully-insured individual, small group, large group and administrative service only (ASO) plans, and Medicare Advantage plans are impacted.

The following plans are NOT impacted:

• ASO plans for which we do not administer the pharmacy benefit and do not provide specialty drug medical management services. 
• State Health Plan members will continue using Express Scripts to administer their pharmacy benefit.

Will members receive a new identification (ID) card?

Members who have their pharmacy and medical benefits through one of our health plans will receive a new ID card. Members can also get an electronic version of their ID card by logging into My Health Toolkit^®.

How does PreCheck MyScript work?

PreCheck MyScript is a Real Time Benefit Check solution that provides patient specific prescription drug cost and coverage information at the point of care in real time. PreCheck MyScript runs a trial claim through our pharmacy claim platform so you can:

• Tell your patient the precise cost of the medication.
• Evaluate therapeutically equivalent medication alternatives, if available, covered under the member-specific benefit design.
• Understand medication coverage, including which medications may not require a prior authorization.
• Submit a PA, often receiving results in seconds.

Why should I use PreCheck MyScript?

PreCheck MyScript allows you to discuss cost and options with your patient while they are in your office and before the prescription is sent to the pharmacy. This can remove cost barriers for patients which can lead to increased medical compliance.

How does PreCheck MyScript make it easier to submit a PA request?

With PreCheck MyScript, there are no forms to fill out and there is no need to send a fax or make a phone call. A PA request can be submitted electronically through the tool you are already working in.

How accurate is PreCheck My Script?

PreCheck MyScript shows:

• The member’s out-of-pocket cost based on the medication being prescribed.
• The pharmacy selected.
• The member’s benefit plan coverage including the deductible.
• The pricing in real time. The price you see on the screen is what is in our pharmacy claim platform for that drug for that particular member’s benefit plan. The pricing information and Prescription Drug List (PDL) are accurate at that point in time and are subject to change.

How does PreCheck MyScript help my patients?

When you prescribe a medication that needs a PA, you will see an alert on your electronic medical record (EMR) screen. The member’s plan-specific information and some questions specific to that drug are pre-populated. Once all required fields are completed, submit the request and you may receive the determination within seconds. PreCheck MyScript also tells you if a prescription is not covered or non-preferred, which is a cost savings to the patient.

Which EMRs are currently using the PreCheck MyScript tool?

PreCheck MyScript seamlessly integrates with the following EMRs, with additional integrations ongoing:

• Allscripts - prescription price transparency
• AthenaHealth - Real-Time Benefit Check
• Cerner*
• DrFirst - myBenefitCheck
• Epic*
• NewCropRx - NewCrop-RTBI
• Veradigm - Veradigm TruePriceRx

*Access is dependent on the Health System

Is there another way to access PreCheck MyScript?

PreCheck MyScript can be accessed on the Pharmacy pages of our websites www.SouthCarolinaBlues.com or www.BlueChoiceSC.com. You can also go directly to the portal. You will need to register to create an account to utilize the tool.

How is PreCheck MyScript improving health care?

PreCheck MyScript provides accurate benefit cost and coverage information at the point of care. This can remove cost barriers for patients which can lead to increased compliance. PreCheck MyScript is a benefit check solution that runs a trial claim. Current users have told us they appreciate being able to discuss actual costs and options with their patients.

How accurate is PreCheck MyScript?

PreCheck MyScript shows the member’s out-of-pocket cost based on the medication being prescribed, the pharmacy selected and the member’s benefit plan coverage as well as the member’s deductible status. The price you see on the screen is what’s in our pharmacy claim platform for that drug at that moment for that particular member’s benefit plan.
The pricing information and Prescription Drug List (PDL) are accurate at that point in time and are subject to change.