Question 1

HOW DOES MY PHARMACY SUBMIT A REIMBURSEMENT APPEAL TO LEADWAY RX?

Accepted Answer

At Leadway Rx, we want to partner with our provider pharmacies to ensure our members are provided the best possible pharmaceutical care.  Our leadership also understands that part of ensuring our members are taken care of, is making sure our network pharmacies are taken care of.  We never want any of our network pharmacies to lose money taking care of our members.  To ensure this doesn't happen, we contract with our network pharmacies to reimburse at competitive but fair reimbursement rates.  If, however, there is an occasion where your pharmacy feels the contracted rates were not applied correctly or if you are underwater on a prescription claim for any of our members, we will remedy the situation as quickly as possible.  If this does happen, please reach out to us to let us know, fill out this "Pharmacy Complaint Form",  and attach the pharmacy invoice showing the price you paid for the member's medication.  We will respond to your request within 5 days, and, should it be found that a reimbursement error or an underwater reimbursement did occur, we will work with you to rectify the claim immediately.
Tennessee pharmacies click here for a more detailed view of the Reimbursement Appeal Process.

Question 2

HOW DO I START A PRIOR AUTHORIZATION FOR A PATIENT?

Accepted Answer

Each individual plan may be different in regards to the exact prior authorization review process.  Call our helpdesk at 888-878-7855, and we'll let you know the process for the member's individual plan of the claim that you are trying to process.  You can also get a quickstart on the process by filling out our Prior Authorization Form.

Question 3

HOW CAN I GET MY PHARMACY IN YOUR PHARMACY PROVIDER NETWORK?

Accepted Answer

We are always looking to expand our network and partner with innovative pharmacy providers to provide innovative personalized care to our members.  We truly care for our members and want them to receive the pharmaceutical care they deserve!  Please call (888-878-7855) or email us (info@LeadwayRx.com), and we'll send you a copy of our Pharmacy Provider Network Agreement for your team's review.

Question 4

HOW CAN MY PHARMACY SUBMIT CLAIMS TO LEADWAY RX?

Accepted Answer

Our current payer sheets are attached here. If you are still having any issues submitting electronic claims to us or have any questions, don't hesitate to call (888-878-7855) or email us (info@LeadwayRx.com), and we'll be glad to help out any way we can.

FAQ'S

HOW DOES MY PHARMACY SUBMIT A REIMBURSEMENT APPEAL TO LEADWAY RX?

HOW DO I START A PRIOR AUTHORIZATION FOR A PATIENT?

HOW CAN I GET MY PHARMACY IN YOUR PHARMACY PROVIDER NETWORK?

HOW CAN MY PHARMACY SUBMIT CLAIMS TO LEADWAY RX?

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