We have now helped to start over 100 pharmacies. As such we have experienced a lot when it comes to obtaining licenses and insurance contracts. Below are some key items to know.
- The order in which you obtain licenses and contracts is
- State Board of Pharmacy,
- then DEA,
- you can get NPI and NCPDP once you have an address,
- then insurance contracts.
- CSOS (Controlled Substance Ordering System) can take 6 weeks
- Your PSAO will obtain most of your insurance contracts other than Medicaid, Caremark, Humana, Express Scripts and Medicare Part B.
- Caremark is a two step process with a pre-questionnaire and then an application.
- Humana is also a two step process.
- Express Scripts requires that you place an order and provide the invoice for your initial invoice in order to apply.
- Optum is making new pharmacies wait 6 months from opening to receive contract.
- Look out for Heat Zones which are Medicare excluded areas that can delay many contracts for up to one year.
