As you are likely aware, starting March 1, 2006 Horizon Blue Cross Blue Shield of New Jersey is requiring its members who take certain "specialty" medications to obtain those medications from one of only four mail order Specialty Pharmacies. TheraPoint by Optioncare has been chosen as one of those Specialty Pharmacies.
We understand that this change may cause some confusion and anxiety for you. You have undoubtedly built a trusting relationship with your local pharmacist who has been providing this medication for you up until now. We know that you may have reservations about not being able to obtain your medication from a local pharmacist who is “just around the corner.”
We want you to know that we are committed to be the ONE Specialty Pharmacy that can give you the level of personal attention that you are used to receiving from your local pharmacy. We hope you will give us the opportunity to earn your trust and build a relationship with you.
We look forward to serving you and to helping you make this transition as smoothly as possible. If you wish to discuss having TheraPoint be your Specialty Pharmacy, call and ask for one of our Intake Nurses Monday through Friday, 8:30 am to 4:30 pm EST
at 1-800-278-2101.
You have a choice. The right choice is TheraPoint by Optioncare.
FAQ's for Horizon Members
Why should I choose TheraPoint by Optioncare to be my Specialty Pharmacy?
• Unlike your other options for mail order pharmacies, as a company we are “big” enough to serve you well but small enough to maintain a personal touch. While we have the experience to safely and efficiently provide your medications by mail order, we are not a huge, impersonal mail order pharmacy. We are first a local and regional pharmacy that also provides medications by mail order… so we are used to treating our mail order patients with the same personal attention that a local patient receives when they walk into one of our Pennsylvania locations.
While all of our staff are more then happy to assist you if you call with a question, issue, or a complaint, you can actually request to speak directly to the owner of our pharmacy. We encourage you to see if you can get that level of personal attention from the other mail order pharmacies on the provider list.
How will you get my medications to me?
• We ship all your medications in strict accordance to the manufacturers’ recommendations, providing insulated shipping packages and ice packs when indicated. We ship most orders via FedEx and can make arrangements with other carriers if special circumstances apply.
What if I have a problem after regular business hours?
• Our hours of operation are 8:30 am to 4:30 pm EST, Monday through Friday. When our offices are not open, we have a registered nurse and a pharmacist on call 24/7 to assist you with any questions you may have about your medication. Simply call 1-800-278-2101. Our answering service will take your name and contact number and then they will page a nurse or pharmacist who will call right back to assist you.
Do I have to call you everytime I need my medicine refilled?
• Our nursing staff uses a sophisticated computer tracking system to determine when your next delivery will be due and we will call you, usually the week before, to confirm what day you will need to receive your delivery. You will never have to worry about being without your medications. Of course, you are always welcome to call us to inquire about your next delivery if you have any concerns.
I want TheraPoint by Optioncare to be my Specialty Pharmacy. How do I get started?
• Simply call 1-800-278-2101 during regular business hours (Monday through Friday, 8:30 am to 4:30 pm EST, closed major holidays) and ask for one of our Intake Nurses.
We will be happy to take your contact information. Some of the important information you will need to have available will be:
- A list of any allergies you may have.
- The name of the medication you will need and why your doctor prescribed it.
- The name and phone number of your current pharmacy.
- The name and phone number of the doctor who prescribed the medication.
- PLEASE have your insurance card with you when you call, including a seperate prescription benifits card if you have one.
Once we have obtained your information, one of our Reimbursement Specialists will then contact Horizon BC to confirm your coverage and any applicable co-pays or deductibles that you may have. Once they have done that, the Reimbursement Specialist will contact you to review that information with you. You can generally expect your co-pays and deductibles to be the same regardless of which pharmacy you choose, as these are determined by your insurance company. Once this information has been reviewed with you, your Reimbursement Specialist will then put you on the line with one of our nurses, who will assist you in scheduling your first delivery.
If you are coming close to being due for your next refill, our Reimbursement Department will receive confirmation from your insurance company and call you back on the same day, or the next business day, from the time you provided us with your information. However, due to the sheer volume of patients that Horizon is requiring to change pharmacies, there may be delays in the time it takes for us to receive a confirmation from your insurer. We will do everything in our power to work with your insurance company to avoid delays, but please be aware that due to circumstances beyond our control, it may take longer than usual for our Reimbursement Specialist to be able to receive that confirmation from Horizon and then contact you.
If you have recently refilled your prescription then it may be too early for us to perform a test claim with your insurer to confirm your coverage. We will notify you if this is the case. Our staff and computer system will then keep track of when will be the earliest date that your insurer will allow us to test your claim. As soon as we are able to verify your benefits we will notify you and then make delivery arrangements.
| 
