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Savings for Policyholders on Workers’ Compensation Prescriptions |
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CompSource Oklahoma has partnered with Healthesystems, a pharmacy benefit management company, to help reduce the cost of workers’ compensation prescriptions through participating pharmacy discounts. The program will pass savings along to policyholders through reduced claim costs while offering convenient delivery of workers’ compensation prescriptions to injured workers. Injured workers are now eligible for this program. Healthesystems has a large pharmacy network, so most injured workers are already using participating pharmacies.
Policyholders can maximize this savings opportunity by ensuring all workers’ compensation prescriptions are processed through a Healthesystems participating pharmacy, including the very first prescription needed. A First Fill Form will be sent to each policyholder to present to newly injured employees to give to their pharmacists for processing first time prescriptions. Additional forms may be obtained by contacting the CompSource Oklahoma Claims Department,
or you can click here to download the form in PDF format.
CompSource is committed to working with policyholders to save on the cost of workers’ compensation prescriptions through this new program. A list of Frequently Asked Questions (FAQs) is provided below to assist policyholders and injured workers with more information about the Healthesystems program. For additional questions or information, please contact the CompSource Claims Call Center at (405) 962-3872 or (800) 462-7966 or send an email to
claims@compsourceok.com.
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What is Healthesystems Pharmacy Benefit Management? |
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Healthesystems, through its large network of participating pharmacies, offers workers’ compensation prescription medications to CompSource at discounted prices. Healthesystems consolidates on-line point-of-sale, paper and mail order transactions into one system. This consolidation means CompSource’s policyholders can expect greater bottom line savings and service. The program works best when participating pharmacies are notified the injured worker is insured by CompSource and consequently covered by Healthesystems so the Healthesystems discount will be applied. Healthesystems additionally provides information about injured worker prescriptions to CompSource to help CompSource determine that the prescriptions purchased are workers’ compensation related and whether a lower cost, generic equivalent is available.
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What are the benefits of the program to policyholders and to injured workers? |
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Policyholders benefit by savings on claim costs due to the discount on workers’ compensation prescriptions. Injured workers benefit by prompt receipt of their workers’ compensation prescriptions from participating pharmacies. They will not have to pay out of pocket expenses, complete request for reimbursement forms, or keep up with receipts. Additionally, injured workers can expect prompt refills from participating pharmacies because their information will already be in the system for electronic approval.
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Do injured workers have to pay out of pocket expenses for workers’ compensation prescriptions filled through Healthesystems? |
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No. CompSource will pay for necessary and reasonable workers’ compensation prescription medications.
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What is the “First-Fill” program? |
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“First-Fill” is a program that allows a pharmacy to contact the Healthesystems Help Desk by phone and establish an injured worker profile prior to Healthesystems receiving claim information from CompSource. The “First-Fill” must be made within the first 15 days of the injury date and allows the injured worker to receive up to a 10-day supply of medications.
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When should the First Fill Form be completed? |
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The First Fill Form should be completed by the employer and given to the newly injured worker to present to the participating pharmacy for the first workers’ compensation prescription needed. The pharmacy will capture and save the pertinent information in its system to facilitate filling future workers’ compensation prescriptions.
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Is an injured worker required to use the First Fill Form? |
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No. However, we encourage that it be used. The employer is encouraged to complete the First Fill Form and give it to their newly injured worker to help ensure the worker’s first prescription is filled without unnecessary delays and to maximize pharmaceutical cost savings. The injured worker is encouraged to give the First Fill Form to the pharmacy at the time the first workers’ compensation prescription is needed to allow the pharmacy to provide faster service on the first prescription, as well as on medications needed later.
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If CompSource does not yet have a claim of injury and the injured worker does not have a First Fill Form, how does he or she get a first prescription filled? |
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The Healthesystems “First Fill” program allows authorization up to a 10-day supply of workers’ compensation medications if the request is made within 15 days from the date of injury. Though a First Fill Form isn’t required to be presented to the pharmacy in order for the worker to get the first prescription filled, it may take the pharmacy longer to fill the initial prescription as they may have to call the Healthesystems Help Desk and/or CompSource claims adjuster to obtain the necessary information and authorization required to fill the prescription. To ensure prompt receipt of prescriptions, use of the First Fill Form is encouraged.
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How can an employer obtain additional First Fill Forms? |
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For additional First Fill Forms, contact the CompSource Claims Call Center at (405) 962-3872 or (800) 462-7966, send an email to claims@compsourceok.com, contact the assigned CompSource claims adjuster, or
download the form here in PDF format.
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How does an injured worker find participating pharmacies? |
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Healthesystems’ pharmacy network is a comprehensive, national network comprised of thousands of participating pharmacies. To search for participating pharmacies near you, visit www.healthesystems.com. If more help is needed, call the CompSource Claims Call Center at (405) 962-3872 or (800) 462-7966, send an email to
claims@compsourceok.com, or contact the assigned CompSource claims adjuster.
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May an injured worker get a workers’ compensation prescription filled out-of-state? |
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Yes, he or she may visit a participating pharmacy out-of-state for workers’ compensation prescription needs. For convenience and faster service, the injured worker should provide a First Fill Form to the out-of-state pharmacy upon the initial visit.
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What if an injured worker does not live near a participating pharmacy? |
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A mail service delivery program is available through Healthesystems. Visit
www.healthesystems.com to learn more about home delivery of workers’ compensation prescriptions. When required, workers’ compensation prescriptions can be filled at non-participating pharmacies. If more help is needed, contact the CompSource Claims Call Center at (405) 962-3872 or (800) 462-7966, send an email to claims@compsourceok.com, or contact the assigned CompSource claims adjuster.
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