Network Pharmacy Support

PDMI supports our pharmacy provider partners with the assistance and information needed for processing claims and ensuring proper outcomes. Please reference the communication directory listed below for all of your questions and requests. Using these channels appropriately will greatly enhance the speed, accuracy, and efficiency of the execution of your needs. Email will typically result in the quickest turnaround time.

Email

• Claims calculation issues, contract issues, affiliation issues
• Enrollment updates, credentialing, contracting requests, pharmacy not contracted
• Appeal Requests including MAC Appeals
• EFT, ACH, 835, remittance, and pay center issues
• Audits and recoveries
• Annual FWA attestation inbox
• Claim Payment inquiry (Pharmacy Use Only)

Mail

ATTENTION:  PHARMACY NETWORK
PDMI
8530 Crossroads Drive
Poland, OH 44514

Pharmacy Manual

Pharmacy Manual

Enrollment Forms

• Pharmacy Network Enrollment
• Part D Attestation 2016
• Participating Pharmacy Compliance, Fraud, Waste, And Abuse (FWA) Attestation
• PDMI Payer Template

Payer and Processing Sheets

• Commercial COB Scenario 2 Payer Sheet
• PACE Payer Sheet

Pharmacy Provider Payment Set-up

• Request for Electronic Funds Transfer
• Request for Electronic Remittance: 835 Payment Reconciliation

Appeal Documents and Resources

Pharmacy Pricing Appeals

MAC Lists and Updates

Tennessee Low-Volume Certification