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Pharmacy Policies & Procedures


Welcome to the online version of Pharmacy Policies and Procedures. This document outlines the administrative policies and procedures applicable to the Medica Pharmacy Participation Agreement (the "Agreement"). Changes and additions to Medica's Policies and Procedures may be made to this document and will be considered amendments to Medica's Policies and Procedures. Pharmacies will be notified of these changes through the Pharmacy Newsletter sent via facsimile.

Table of Contents

Introduction
Section 1 - Eligibility
Section 2 - Online Claims
Section 3 - Prior Authorization Formulary
Section 4 - Pharmacy Audit
Section 5 - General Claims Information
Section 6 - Online DUR