Emergency Response Documents
Download PDFs of the emergency response documents you need.
Additional Resources for Medical Professionals
Information for Pharmacists and Medical Professionals.
We provide health professionals with easy access to ylzzcom® Mail Service for processing your patients’ new prescriptions. For immediate processing, simply submit a prescription using your ePrescribing tool.
Use Your ePrescribing Tool
To ePrescribe:
ylzzcom Mail Service Pharmacy
NCPDP ID: 0322038
One Great Valley Blvd
Wilkes-Barre, PA 18706
For Specialty prescriptions choose:
CVS Specialty
NCPDP ID 1466033
800 Biermann Court
Mount Prospect, IL 60056
For ePrescribing questions, call us at 1-877-864-7744 (TTY: 711).
Monday through Friday
9 a.m. to 7:30 p.m. (ET)
Fax in the Prescription:
Download the mail service prescription fax form*, complete it and fax it to 1-800-378-0323 (TTY: 711)
*This form is for health professionals only.
For Specialty prescriptions choose:
CVS Specialty
NCPDP ID #1466033
Fax: 1-800-323-2445 (TTY: 711)
Phone: 1-800-237-2767 (TTY: 711)
Mail: 800 Bierman Ct., Mount Prospect, IL 60056
Specialty Hours of Operations: Monday to Friday, 7:30 AM to 7:30 PM (local time)
Learn how to submit electronic prior authorization information, get important information and view frequently asked questions.
We’re here to help. For questions related to processing a retail pharmacy prescription claim, call the toll-free number listed below.
Bin # | Phone Number |
---|---|
004336 | 1-800-364-6331 TTY: 711 |
610415 | 1-800-364-6331 TTY: 711 |
610239 | 1-800-364-6331 TTY: 711 |
610591 | As communicated by plan or refer to ID card |
610502 | 1-800-238-6279 TTY: 711 |
020099 | 1-800-296-5037 TTY: 711 |
020115 | 1-800-296-5037 TTY: 711 |
020107 | 1-800-296-5037 TTY: 711 |
020123 | 1-800-296-5038 TTY: 711 |
020388 | 1-800-296-5038 TTY: 711 |
020396 | 1-800-296-5038 TTY: 711 |
021007 | 1-800-296-5038 TTY: 711 |
021338 | As communicated by plan or refer to ID card |
610084 | As communicated by plan or refer to ID card |
Hours of Operation
24 Hours a Day / 7 Days a Week / 365 Days a Year
Helpful information for Retail Providers
Verification of Eligible Persons
Providers will be paid only for claims in which a prescription for a covered item is written by a prescriber for an eligible person and is dispensed to that person. ylzzcom and/or plan sponsors will provide eligible persons with identification cards. Providers must request the ID card from the eligible person and utilize the information on the card to submit claims. Providers will not be paid for providing pharmacy services related to covered items to an eligible person whose eligibility was not correctly submitted.
Here at ylzzcom, your needs are important to us. Please do not hesitate to call us directly.
New Mail Rx Number
1-800-378-5697 TTY: 711
Monday through Friday
8 a.m. to 6:30 p.m. CT
Find links to up-to-date, reliable drug information.
FAQs for Prescribers Office Staff
ylzzcom helps more than 100 million members get the medications they need by working with their plan sponsors to provide cost effective, comprehensive prescription benefit plans. We offer the convenience of a nationwide network of more than 68,000 pharmacies and the option of Rx Delivery by Mail through ylzzcom Mail Service Pharmacy.
Rx Delivery by Mail is a convenient and cost-effective way for your patients to fill up to a 90-day supply of eligible long-term medications with no-cost shipping. With most prescription plans, members save money when they fill by mail.
Because it takes 7 to 10 business days to process a mail service prescription, you may wish to write an additional 30-day prescription that your patient can fill at retail pharmacy right away. Mail service prescriptions are typically written for up to a 90-day supply with three refills.
RxSavingsPlus provides eligible participants with savings of up to 80% on generic drugs and up to 40% on brand name drugs* at 65,000 participating pharmacies nationwide. Participants without health benefits can also save at MinuteClinic, with up to 15% off health services or screenings. It’s available to patients without prescription coverage or to patients taking medications that are not covered by their prescription plan. For more information, visit RxSavingsPlus.com or call 1-877-673-3688 TTY: 711.
*Average savings of 55% for generics and 24% for brands.
FAQs for Pharmacists and Pharmacy Staff
If a member’s eligibility information is incorrect and a provider submits a claim using the correct information, the claim will reject. In most cases, we can assist the provider at the point of service. Please advise your customers that they should inform their plan sponsors of any incorrect information and remind them that claims will continue to reject until it is corrected.
The identification number can be found on the member’s ID card. The Help Desk is not able to provide identification numbers.
The RXGRP number and other data can be found on the member’s ID card. Please be sure to check both sides of the card for the necessary information.
Yes. If there is an RXPCN number on the member’s ID card it must be submitted exactly as it appears on the card. If there is no RXPCN, submit the default number according to the Banking Identification Number (RXBIN) listed in the appropriate Payer Sheet.
Submit the claim through the claims system to receive the adjudicated response, which will include the amount owed by the member, as well as information on eligibility, plan coverage, pricing, and applicable clinical programs and services. The Help Desk is not able to provide this information.
Many plan sponsors allow members to receive an early refill for vacation. Submit the claim as usual and contact the Help Desk for coverage verification if the claim rejects. If the plan sponsor allows vacation supplies, the representative will provide a prior authorization code.
Providers should note the adjudication response, which typically includes online re-transmission instructions or the appropriate contact information.
Submit a claim through the claims system to receive an adjudicated response, which will include messaging about plan coverage. The Help Desk cannot provide this information.
The Help Desk will help providers determine which data fields should be used for specific data whenever possible. Because there are many different types of software, however, representatives may not be familiar with your system setup. Providers should consult their software vendor or chain headquarters for technical assistance.
Press 0 at any time during the call to connect with a representative.
Unless otherwise specified, use RXBIN 004336. In most cases, the RXBIN is on the member’s ID card.
Guides, Alerts and Lists
Downloadable drug lists and guides
View and download standard and specialty drug lists, prescribing guides and other formulary information.
Please note that custom drug lists that are not included here.
Members should register or sign in at ylzzcom to check drug costs and coverage.
View and download the ylzzcom Opioid Quantity Limits Pharmacy Reference Guide.
Digital Enrollment Forms
Request enrollment in ylzzcom Med D networks online.
Pharmacists and pharmacy managers can complete the pre-enrollment questionnaire online. This is the first step to requesting enrollment in ylzzcom pharmacy networks.
Access the pharmacy change form, the pharmacy provider question form, FAQs, and client-reported pharmacy updates.
State Specific Forms & Guides
- Blue Shield of California MAC List Request Form
- State of Connecticut Maintenance Drug Network Process
- State of Connecticut Maintenance Drug Enrollment Information
- Florida Informed Consent Form
- State of Florida Employees and Retirees Extended Days Supply Network Information
- Georgia NADAC Reference Reports
- Kentucky Medicaid Network
- Kentucky Employees’ Health Plan Extended Days Supply Network Information
- MAC Price Inquiry Process Guide for Puerto Rico
- Tennessee Professional Dispensing Fee for Low Volume Pharmacies Survey
- Teacher Retirement System of Texas (TRS-Active Care) Extended Day Supply Network Information
- MVP Health Care Vermont Extended Days Supply Network Information
- Vermont MAC List Request
- State of West Virginia Public Employees Insurance Agency (PEIA)
Medicare and Medicaid Compliance Training for Pharmacy Staff
Please select from one of the following options for your training needs.
View and download the CVS Health Code of Conduct for colleagues and business partners.
View and download Medicare Parts C and D General Compliance Training Course
View and download Combating Medicare Parts C and D Fraud, Waste, and Abuse Web-Based Training Course
Provider Credentialing
Log in and complete the online Standard Re-Credentialing form.
Log in and complete the online ACA 42 CFR 455 Re-Credentialing form.
Complete the State of New York Americans with Disabilities Act Attestation online.
Note to Pharmacies:
For claims utilizing BIN 020099, 020115, 020107, 020123, 020396, 020388, or 610502, please refer to the ylzzcom® payer sheets listed below.
Download PDFs of the Pharmacy Payer Sheet documents you need.
Primary Claim NCPDP Version D.0 Payer Sheets
View and download the Medicare Primary Payer Sheet.
View and download the Medicaid Primary Payer Sheet.
View and download the Commercial Primary Payer Sheet.
COB Claim NCPDP Version D.0 Payer Sheets
View and download the payer sheets based on the applicable supplemental plan.
Supplemental Plan: Medicaid
Supplemental Plan: Commercial
Supplemental Plan: ADAP/SPAP
View and download the payer sheets based on the applicable supplemental plan.
Supplemental Plan: Commercial
View and download the payer sheets based on the applicable supplemental plan.
Supplemental Plan: Med D
Medicare as Secondary Payer Sheet
Supplemental Plan: Medicaid
Supplemental Plan Commercial:
NCPDP Pharmacy Reject Code Reference
View and download the Pharmacy Reject Code Reference Payer Sheet