The Mississippi Coordinated Access Network (MSCAN) Coordinated Care Organizations (CCOs) must reimburse network providers in accordance with Division of Medicaid (DOM) policies.
The DOM Office of Pharmacy has received inquiries from pharmacy providers concerning MSCAN reimbursement and remittance advice statements. The Magnolia Health Plan’s and UnitedHealthcare Community Plan’s Pharmacy Benefit Managers (PBMs), Envolve Pharmacy Solutions and OptumRx, have advised DOM that they have identified and corrected reimbursement and reprocessing issues for certain dates of service. Details regarding these issues can be found at:
- Magnolia website
- UHC website – Refer to ‘Pharmacy Provider Notice of Claims Processing Errors, under ‘Pharmacy Bulletins’
Pharmacy providers are encouraged to contact the CCOs directly. Contact information can be found below.
Magnolia Health Plan – Envolve Pharmacy Solutions
For a list of impacted claims, contact:
Envolve Accounts Payable
Phone: (559) 244-3748
For all other questions, contact:
Mississippi Magnolia Help Desk
Phone: (866) 912-6285, ext. 66409
UnitedHealthcare – OptumRx
For all questions, contact:
Mississippi UnitedHealthcare Pharmacy Office
Phone: (601) 718-6579