Colorado Prescription Drug Services
RMHP offers many great services to support you in prescribing the most appropriate, cost effective medications for your patients. Learn more about these services and access detailed RMHP formulary and pharmacy provider information here.
Pharmaceutical Management Procedures
Request prior authorization for drugs:
You will find criteria for each drug, as well as the RMHP Coverage Policy by clicking on one of the links listed below. Locate the PDF file for the drug you wish to prior authorize, complete the criteria form and fax it to the RMHP Pharmacy Help Desk at 970-248-5034
Drugs that require prior authorization for Commercial and Medicaid
Drugs that require prior authorization for Medicare D and Medicare B
Request coverage of Non-Formulary drugs:
Validate that the drug you are requesting a Formulary Exception for is not included on a formulary by clicking on the appropriate formulary links below. If the drug is not included on the formulary, please print and complete the appropriate exception form and fax it to the RMHP Pharmacy Help Desk at 970-248-5034.
Good Health Commercial Formulary
Commercial Form Link
Medicare D Premier Formulary
Medicare D Form Link
Determine which drugs require Step Therapies:
Drugs requiring Step Therapy are included in the formulary as ST. Drugs designated as ST will be flagged in the formulary with the required alternative drug(s). A therapeutic trial of a drug must be used prior to coverage of a drug that requires Step Therapy.
Commercial/Medicaid Step Therapy List
Medicare D Step Therapy List
Determine which drugs have quantity limits:
Drugs that have quantity limits are identified in the formularies with a QL (quantity/days supply).
For a complete list of all Formulary Policy Indicators, please go to the Good Health Commercial Formulary or the Premier Medicare D Formulary.
Epocrates Handheld Drug Database
This convenient, handheld drug database, which runs on Black Berry, iPhone and Android handheld devices as well as desktop PC’s, has clinical and formulary information for almost 3,000 drugs. Using Epocrates you can look up:
- RMHP Medicare formulary status for any drug
- Adult and pediatric dosing
- Side effects and interactions
- Drug costs
- Generic or lower-cost alternatives
Easy access to this information not only saves you time, it helps reduce the chance of prescribing errors, frustration with insurance formularies, delays, pharmacist call-backs, and unexpected costs. You can download Epocrates Rx FREE or you can select an enhanced version at the subscription rate.
WellDyneRx Mail Service Pharmacy
- Log onto www.myWDRX.com to request a refill online or check the status of an order or call WellDyneRx at 888-479-2000 to place an order by phone
Home Delivery Pharmacies
RMHP now contracts with two home delivery pharmacies. Members are free to choose whichever pharmacy they wish to use.
Express Scripts Home Delivery Pharmacy
- Call Express Scripts at 866-503-5409 to place an order by phone
Drug Information and Formularies Preferred Drug List Detailed formularies Recent Changes to Drug Formularies Medicare Part D Formulary changes Pharmacy Resources NCPDP vD 0 Commercial Payer Sheet 1/1/13 NCPDP vD 0 Medicare Payer Sheet 1/1/13 NCPDP vD 0 Medicaid Payer Sheet 1/1/13 CMS Notice of Appeal Rights D.0 New Reject Codes D.0 Reject Explanations D.0 Compound Claims Processing D.0 FAQ