To determine if pharmacy benefits are payable by Clear Health Alliance, please confirm the requested services are a covered benefit. Questions about members’ pharmacy benefits can be answered by calling our Pharmacy Department at 877-577-9044 between 8 a.m. to 8 p.m. Eastern time, Monday through Friday.
Please refer to the Preferred Drug List (PDL) when prescribing for our members. This guide does not contain a complete list of drugs; rather, it lists the preferred drugs within the most commonly prescribed therapeutic categories.
Though most medications on the PDL are covered without precertification, a few agents will require you to contact our Pharmacy Department for authorization.
Ensure our members are equipped to renew their Medicaid Benefits
Help our members prepare to renew their Medicaid healthcare coverage and benefits by educating them on what documents are needed to ensure their renewal form is completed accurately. Members can submit their renewal form via web (preferred), phone, fax, mail, or in person.
If you have questions about eligibility, benefits, authorizations, claims status, and more, log in to Availity Essentials* and select Chat with Payer. For additional support, please use the following resources or contact us if more clarification is needed.
The Availity Portal offers health care professionals free access to real-time information and instant responses in a consistent format regardless of the payer.
Find learning opportunities to assist with administering your patient’s health plan using Availity Essentials multi-payer features and payer spaces applications. Use the library of self-paced courses and instructor-led training sessions, available 24/7 at no cost. Be prepared with the knowledge to assist our members.
At Availity you can:
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Search for up-to-date drug information, including hundreds of brand-name and generic medications.
Maternal Child Program
When it comes to our pregnant members, we are committed to keeping both mom and baby healthy. We encourage all our moms-to-be to take part in the Taking Care of Baby and Me® program, a comprehensive, proactive case management and care coordination program for all expectant mothers and their newborns.
Behavioral health provider
We work collaboratively with hospitals, group practices and independent behavioral health care providers, community and government agencies, human service districts and other resources to successfully meet the needs of members with mental health, substance use, and intellectual and developmental disabilities.