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MedXpress

UPDATE 12 OCTOBER 2020 :

REDDAM PHARMACY IS A CONTRACTED DISCOVERY MEDXPRESS PHARMACY 

We are aware of the communication received by some of our clients from Discovery Health regarding our MedXpress Status.

Unfortunately we did not receive this communication  Directly From Discovery , instead heard from our clients.

We have investigated this and realize we are short a small percentage target for compliance.

This does involve intervention from our side to dispense medication on the Discovery Formulary.

We are currently working hard to maintain this status and will update this page as soon as we find out our Status for November 2020.

We do need your assistance and support to continue being a Discovery MedXpress Pharmacy and to serve you without any penalties or co-payments.

We ask for your co-operation and patience with our Dispensary Staff over the next few weeks.

Kind Regards

Redaa

 

What is Discovery MedExpress?

Discovery MedXpress is administered by Discovery Health and services a small subset of the total chronic member base. Discovery MedXpress routes orders to a MedXpress partner pharmacy. These independently owned, registered pharmacies, assume all the clinical responsibility in dispensing and handling the prescriptions.

MedXpress Network Pharmacies

To afford retail and community pharmacies equal opportunities, we created the MedXpress pharmacy network.

MedXpress network pharmacies are the designated service provider (DSP) for all approved, chronic medicine for Discovery Health Medical Scheme members on Delta, Priority, Saver and Core plans. This means that members on one of these plans must use a MedXpress Network Pharmacy, in order to avoid a 20% co-payment on their approved, chronic medicine. Pharmacies can participate in the network by reaching MedXpress formulary compliance criteria.

This means that the pharmacy will not attract a 20% non-DSP co-payment on chronic medicines for members that use MedXpress as their designated service provider. Only contracted Discovery Health network pharmacies, charging the agreed Discovery Health tariffs and who meet the MedXpress formulary compliance criteria, are eligible to participate in the MedXpress pharmacy network. Pharmacy contracts that charge rates over and above the agreed Discovery Health Rate will be terminated.

Requirements for participation in DSP pharmacy networks

MedXpress pharmacy network

Participation in the MedXpress pharmacy network is open to all contracted network pharmacies that meet the participation criteria. The participation criteria are based on pharmacies’ compliance with Discovery Health Medical Scheme’s formulary. We monitor and report back monthly to pharmacies on formulary compliance. We review pharmacies’ performace on a four monthly basis for inclusion in the network.

To be eligible for inclusion in the MedXpress DSP pharmacy network, we require compliance with the Discovery Health Chronic Illness Benefit (CIB) formulary and oncology preferred product list. The formulary adheres to legal requirements as set out in the Prescribed Minimum Benefit (PMB) legislation and treatment algorithms for specific conditions on the Chronic Disease List (CDL).

MedXpress pharmacy network participation criteria

2020 criteria
Chronic Illness Benefit: we require a minimum compliance to the chronic medicine formulary over a rolling a six month period of:

Performance Based Remuneration (PBR) compliance of ≥52%,

OR

PBR substitutable compliance of ≥80%

AND

Chronic substitutable formulary compliance of ≥82% (measuring HIV and oncology separately).

 Oncology Benefit:

In addition to the above, we also require:

Oncology preferred product list compliance of ≥95%

If you have any more questions simply click the Whatsapp Button on the bottom right of your screen (0833007720)

call us on 0217014001 or

email rx@reddampharmacy.co.za

We thank you for your continued support and look forward to be of service to you and your family