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Pharmaceutical Manufacturers: Disputes Resolution

Disputes Resolution

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Contact the TRICARE Retail Refund Team and FAQs
Q1:

In my data there looks to be duplicates of the same Rx number filled on the same date of service. Is that possible?

A:

Yes. Examples of this occurring are when a child needs one inhaler for school and one for home. Patients also may need to get more than one fill if they are going on vacation, lost their medication or the doctor has increased the dosage. It is important to take this into consideration when disputing utilization data.

Q2:

My K codes have been rejected, but I know that these are 340b pharmacies.

A:

340b pharmacies are retail pharmacies that may service a variety of patients.  DHA requires that a Manufacturer TRICARE Retail Refund 340b Verification Form be completed by the pharmacy before we are able to accept these disputes. 

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Q3:

What pharmacies are eligible for the TRICARE Retail Refund Program?

A:

From the TRICARE Retail Refund Manufacturer Policy and Procedure Guide, a TRICARE retail pharmacy includes long term care facilities, specialty pharmacies, pharmacies inside a physician's office and hospital, and all other pharmacies identified as part of the TRICARE Retail Network.

DHA Address: 7700 Arlington Boulevard | Suite 5101 | Falls Church, VA | 22042-5101

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