IlliniCare Health has programs in place for all of our members. These programs are to make sure that members get safe and the right care. Our programs include current review of claims. The program also includes historic reviews of claims. These reviews are in place to reduce drug errors that cause adverse drug interactions. The reviews also help to avoid use of drugs that are alike at the same time. Our reviews are important for members who have more than one doctor who is prescribing medications, use more than one drug, or have more than one pharmacy.
Last Updated: 02/08/2018
Our plan has programs in place to ensure you receive safe and appropriate care. Our programs include current and historic review of claims. These reviews are in place to reduce drug errors that cause adverse drug interactions. Our reviews are important if you use more than one drug, have more than one pharmacy, or have more than one doctor who is prescribing drugs.
Drug and Utilization Review Programs
When a pharmacy sends a prescription claim, we look at the claim for:
- Age related problems.
- Overuse and underuse.
- Issues with other drugs you take.
- Issues with a disease you have.
- Wrong drug dosage.
- Wrong length of therapy.
- Drug/allergy issues.
- Abuse or misuse.
For questions about our quality programs contact Member Services.
Information last updated: 02/08/2019