¢« Member customer service, standard business hours
* 1099s prepared and delivered to Providers
* Residency-based assessments and/or surcharges and other legislative reporting requirements
* Member eServices
Prescription Benefit Services
* Mail Order pharmacy
* Specialty Pharmacy Services
* Prescription eServices
- Pharmacy locator
- Online formulary
* Point of sale claims processing
* Mail order claims processing
* Mail order call center with toll free number
« Mail order regular shipping and handling
* Standard management reports
* Ad hoc reports (subject to additional programming charge if required)
¢ Concurrent Drug Utilization Review (DUR) programs
* Retrospective DURs
¢ Administrative override (i.e., vacation, lost, stolen or spilled medications)
* Clinical review
* Pharmacy help desk with toll free number
« Pharmacy audits (desk and onsite; routine, in depth or focused)
Health Care Management and 360 Health Services
« Health Care Management
- Referrals
- Utilization management
- Case management
- Anthem Medical Policy
« SpecialOffers
« HealthCare Advisor
* Care Comparison (where available)
* Transplant services - Blues Distinction
Enterprise Administrative Services Agreement — October 2012 Master Template
City of Nashua 06/17/2013
27
