WellSense ACO Pharmacy

WellSense ACO Pharmacy Update: Process for Supply Chain Issues

The WellSense pharmacy team has shared the following process for providers if there is a supply access issue. In general, the provider would need to search for an alternative in-network pharmacy by using the pharmacy search tool. The pharmacy search tool is available for both ACO members and providers.

Click here to access the pharmacy search tool reference guide.

If the provider cannot find an in-network pharmacy with access to the medication, they should reach out to pharmacym mailbox. The pharmacym mailbox (pharmacym@wellsense.org) is a resource for providers to reach out to for claims specific escalations, including supply issues. 

When reaching out to the pharmacy mailbox, providers should include:

  • Member info (name, DOB, WS ID #)
  • Drug info (drug name and strength)
  • Pharmacy info (pharmacy name)
  • Time / Urgency information (e.g., refill due date)
  • Example: I am looking for assistance with a prescription I sent to Accredo for Tadalafil 10 mg for patient Toi Story, DOB 2/2/2022, WS ID#123456789. Patient will be out of medication in two days. 
Please click this link to view, download and print the Pharmacy Formulary Impact Tool
Please click the following link to be directed to the Mass Health Drug Formulary https://mhdl.pharmacy.services.conduent.com/MHDL/

For more information please contact Carol Freedman at carol.freedman@lahey.org or at 978-380-4089.