Frequently Asked Questions
Who can I call about my pharmacy benefits?
Starting 11/4/24, please contact the Prime Therapeutics Call Center at 844-575-7887
Is there any change to what pharmacy I can use to fill my prescriptions?
No.
How do I request a new or replacement pharmacy ID card?
Please contact Department of Human Services (DHS) at 800-657-3672
What if my pharmacy claim is denied?
Starting 11/4/24, please contact the Prime Therapeutics Call Center at 844-575-7887
What if I need a prior authorization?
Starting 11/4/2024, a prior authorization may be electronically submitted through CoverMyMeds by visiting https://www.covermymeds.health/, calling 844-575-7887, or faxing the request to 866-390-2778. If submitting a Physician Administered Drug (PAD) request please utilize the Medical Prior Authorization Form or if completing via CoverMyMeds enter NDC quantity to prevent delays.
Who can I call about my medical benefits?
Please contact Department of Human Services (DHS) at 800-657-3672
If I am enrolled with a Managed Care Organization (MCO) is there any change to how I access pharmacy benefits?
No. Only the fee-for-service program is moving to a new claims processing system. If you have questions about your pharmacy benefit and you are enrolled with a MCO, please contact your MCO.
How do I become a Medicaid Provider?
You must apply through DHS Provider Enrollment.
Where do I find provider on-line training?
The Provider online training video can be requested by fillinf out the Provider Training form.
How do I find the new BIN, and PCN and Group?
Updated payer specs will be posted this summer. However, as of 10/1/2024 the new BIN is 026787, the new PCN is 5309662024, and the new Group is MNMEDICAID.
What is the System availability for submitting claims?
Prime Therapeutics is available for claims submission daily (24/7/365). Occasionally maintenance will need to be done to the system and that will typically occur on , Sundays from 12:00 A.M. to 2:00 A.M. CT. If maintenance is not needed, the system will remain available for claims processing.
Who do I contact concerning pharmacy claims processing?
Starting 11/4/24, please contact the Prime Therapeutics Call Center at 844-575-7887