When your pharmacy submits a medication claim, they indicate the number of tablets as well as the number of days that the prescription was written for you. Your benefit plan allows you to refill your medications once you are 80%* through the previous supply. If your doctor has increased your dose and the pharmacy feels that it is appropriate to dispense the medication early for this reason, they are able to do so. They would simply need to enter an intervention code when they submit your claim that indicates that there has been a dose change. Please note that the option to override the denied claim is at the pharmacist's discretion. Your pharmacy can access a list of intervention codes on Provider Connect.
*Note: 80% is an administrative guideline, benefit plans may differ.
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