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Pharmacy Issues Clarification

October 31, 2018

UnitedHealthcare provided the below clarification regarding pharmacy issues:

The correct phone number for prescribers to call inquiring about pharmacy rejections referencing "prescriber not on file" is the UHC IA Provider Services: 1-888-650-3462. Provider Services should then be emailing the pharmacy team to review and respond back to Provider Services on what the issue is. Various responses from the pharmacy department might be:
• That the provider has been identified on the state provider file and therefore has now been loaded into the Iowa Prescribing Network with prescriptions appropriately processing.
• The provider is not on the state provider file and therefore cannot be loaded into the Iowa Prescribing Network. If there are questions regarding prescriber enrollment with Iowa Medicaid, or questions as to why the prescriber is not on the state file if the prescriber did enroll, please contact the IME Provider Services Unit at 1-800-338-7909, or by email at imeproviderservices@dhs.state.ia.us.


Following Iowa Medicaid policy (Informational Letter 1913), prescribing providers must be enrolled with Iowa Medicaid in order to be added into the UnitedHealthcare Iowa Pharmacy Prescribing Network. The source of truth UnitedHealthcare uses to identify enrolled prescribers to be added to the network is the Provider File we receive from the State. If prescribers are not on the State Provider File, they are not added into the network and prescriptions will reject at the pharmacy point of sale for “Missing Medicaid ID/Prescriber not on file.” UnitedHealthcare is ensuring and following state policy that all prescribing providers are enrolled with Iowa Medicaid.
UnitedHealthcare can research to see if a specific prescriber is loaded into the Iowa Prescribing Network if the name and NPI of the physician is provided. If there are questions regarding prescriber enrollment with Iowa Medicaid, please contact the IME Provider Services Unit at 1-800-338-7909, or by email at imeproviderservices@dhs.state.ia.us.