PBH Outpatient Prescription and Laboratory Policies
Published: October, 2001
Clinicians with prescriptive authority should remember:
PBH benefit plans do not cover medications. PBH is not
responsible for determining which medications will be covered
under a specific formulary.
For PBH members who also have PacifiCare medical insurance,
providers may request a fax copy of the PacifiCare Health
Systems outpatient drug formulary by calling (800) 527-0531.
PBH recommends that providers work with members to review
the procedure for coverage of medications under their medical
plan.
Laboratory tests for medications may require coordination
with the primary care physician or medical group.
PBH providers can contact the Provider Helpline
at (800) 716-1166 for assistance with medication benefit issues.
