1- What is the frequency of the benefits?

This is determined by the plan but generally the benefit is provided monthly.

2- Can the members exceed their benefit during the given period?

Our system is set up to prevent exceeding the benefit amount.

3- Can the member carry forward a balance?

This is a “use it or lose it” benefit.

4- Can a member order multiple times during the same period?

The member can only place one order during the given period.

5- How can the members order their benefits?

Online, fax, phone or mail.

6- Can OTCHS receive metrics regarding member ordering?

Yes, we can tailor reports to meet individual Health Plans requirements.

7- How does OTCHS verify member eligibility?

We upload eligibility files from the plans via secure FTP site and this provides the member eligibility.

8- What kind of eligibility files is OTCHS capable of receiving?

We work with most files: flat files, 834, 5010 etc.

9- How do OTCHS and the Health Plan exchange data?

Via secure FTP sites.

10- How often does OTCHS receive eligibility files?

We can receive daily files but the most common practice is a weekly file.

11- How is the formulary chosen?

We work with the plans CMO and our Purchasing team to determine the formulary.

12- Are the products on the formulary brand or generic?

Either option is available. However, most plans choose generic products because they provide the members with more purchasing power.

13- How often does the formulary change?

Once a year.

14- How quickly are orders processed? Shipped?

Orders are entered into the system within 24-48 hours of receipt. Once entered into the system, they are shipped within 48 hours.

15- How does OTCHS ship packages?

USPS Parcel Post directly to the member’s home.

16- Where can OTCHS ship the benefits?

Anywhere in the United States.