Providers Portal

Provider Log In

Pharmacy Help Desk 

ACAA  1-866-224-0176 
AHM 1-855-831-3592 
First Medical 1-855-831-3591
First+Plus 1-855-831-3595
PICA 1-866-993-7422 
PSM 1-855-831-3594 
PROSSAM 1-855-831-3593
UPR 1-866-578-7274
Compliance & FWA  
Hotline             1-855-831-3596


Plan Sponsor Announcements

New Clients Effective January 1, 2013: American Health Medicare (AHM), First Medical, PROSSAM - see document for processing requirements (e.g., RxBIN, RxPCN, RxGroup).

Clientes nuevos efectivo a 1 de enero de 2013: American Health Medicare (AHM), First Medical, PROSSAM - ver documento para requerimientos de procesamiento (RxBIN, RxPCN, RxGroup).

Compliance & FWA Resources

Medicare Compliance and FWA Training (revised 02/2013)

General Pharmacy Operations Resources

New! Health Care Claim Payment Provider Manual (EOP X12 835)

Drug Price Appeal Request Form (English) (revised 03/2013)

Solicitud de Apelación de Precio de Medicamentos (revisado en 03/2013)

Manual Reversal Request Form (English) (revised 03/2013)

Solicitud de Reverso Manual (revisado en 01/2013)

Pharmacy Manual (English) (revised 02/2013)

Manual de Farmacia (revisado en 02/2013)

Registro de Firmas de Reclamaciones de Farmacia

Pharmacy Rejection Codes - No-Charge Rejection Codes (revised on 01/2013)

NCPDP Universal Claim Form - Sample and Instructions

CMS Beneficiary Pharmacy Notice for Medicare Part D Beneficiaries

Notificación de CMS de Farmacia para los Beneficiarios de Medicare Parte D

Formulario de Quejas

Payer Sheets

Medicare Part D Plans Payer Sheet (revised on 12/5/2012)

Commercial/ Non-Medicare Plans Payer Sheet (revised on 12/18/2012)