Office of Vermont Health Access                                 

IMPORTANT: NEW PROCEDURES! 

PHARMACY PROGRAM CALL CENTER SUPPORT

We are committed to providing timely telephone assistance to pharmacies that provide service to our beneficiaries.  Therefore, we have streamlined our Pharmacy Program Call Center Support protocols provided through MedMetrics Health Partners.

This document clarifies what type and level of support you can expect
to receive at our Call Centers.  Please retain it for your reference.

MedMetrics Pharmacy Call Center                1-800-918-7545

Hours of Operation                                           
7 days a week, 24 hours a day

Our Pharmacy Call Center assists Pharmacies with any claims processing issues they might be experiencing. The Pharmacy Call Center can help Pharmacies with all claims processing messages including those that are for standard NCPDP and Medicaid reasons; for example, DUR, Days Supply, COB, or Federal Rebate issues and those that MedMetrics Health Partners created to be unique for Vermont’s publicly funded programs. If the Pharmacy Call Center cannot resolve a Pharmacy’s problem, the call will be referred to the appropriate department or call center for resolution.

MedMetrics Prescriber Call Center              1-800- 918-7549

Hours of Operation                                           
7 days a week, 24 hours a day

The Prescriber Call Center is staffed with Clinical Pharmacists and Pharmacy Associates who field Prescriber calls.  The Prescriber Call Center manages calls for all Prior Authorization reviews or inquiries from Prescribers regarding other types of clinical edits.  They should not be utilized for routine claims processing issues and these calls will be re-directed to the Pharmacy Call Center for assistance.

EDS Provider Call Center               1-800-925-1706 (in-state)

                                                   1-802-878-7871 (out-of-state)

Hours of Operation                   M-F 8:00 AM – 5:00 PM (excluding holidays)

The EDS Call Center should be contacted for any issues related to pharmacy or prescriber enrollment, prescriber NPI issues, or questions related to your Remittance Advice (RA).

Maximus Member Services (Eligibility)                                    1-800-250-8427

Hours of Operation                   M-F 8:00 AM – 4:30 PM (excluding holidays)

The Maximus Call Center should be utilized for any eligibility-related issues, or any time a member needs support in understanding the pharmacy benefit.  Feel free to share this number with your pharmacy customers as needed.

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