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Quality Assurance

Our plan has programs in place for all of our members to ensure you receive safe and appropriate care. Our programs include current and historic review of claims. These reviews are in place to reduce drug errors that cause adverse drug interactions. Our reviews are important if you use more than one drug, have more than one pharmacy, or have more than one doctor who is prescribing drugs.

Drug and Utilization Review Programs

When a pharmacy sends a prescription claim, we look at the claim for:

  • Age related problems
  • Gender related problems
  • Overuse and underuse
  • Issues with other drugs you take
  • Issues with a disease you have
  • Wrong drug dosage
  • Wrong length of therapy
  • Drug/allergy issues
  • Abuse or misuse

For questions about our quality programs contact Member Services.

Information last updated: 07/11/2018