What is HometownRX?
HometownRx provides online prescription benefit management services through more than 47,000 pharmacies throughout the United States and Puerto Rico.
With a nationwide electronic network linking pharmacy and payment services, HometownRx provides convenient, paperless access for members and administrators.
HometownRx specializes in the service of small to medium sized clients with an unlimited range of program goals and business perspectives. We take pride in responding quickly and appropriately to each client's specific needs. From operational and technical to cost and care management, HometownRx is dedicated to providing practical, customized solutions to all of our customers.
Our focus is to help our customers maximize their prescription benefit while minimizing overall costs. We accomplish this by providing efficient pharmacy claims processing at the point-of-sale and attentive account management on the back end. HometownRx excels at Saving time and money.
How do I know what information to adjudicate for a HometownRx member?
Each member will need you to adjudicate specific information to access his or her prescription benefit and to determine drug coverage. Refer to the member's prescription benefit card. The prescription benefit card should contain the member's first and last name, identification number, group number, applicable RxPCN, and the Hometown RxBIN. If you require further assistance, please contact the customer contact center toll-free at (800) 247-4526.
What bank identification number (BIN) do I use for all HometownRx members?
Pharmacies should submit claims utilizing the HometownRx bank identification number (BIN): 600518. In most cases, the BIN is illustrated on the prescription benefit card following RxBIN.
How do I determine if my pharmacy participates in the network that serves a specific plan sponsor?
HometownRx customer service representatives will help determine whether a pharmacy participates in the network that provides pharmacy-related services for a specific plan sponsor.
Can you send me a copy of the HometownRx formulary?
As a third-party processor, HometownRx typically does not distribute formularies to pharmacies on behalf of our plan sponsors. However, to print a list of medications covered within a specific drug class from one of our standard formularies, click here.
Who do I call about payment information?
Contact the pharmacy help desk at (800) 247-4526 and the call/issue will be routed to the appropriate department.
What should I do if a claim rejects for a specific plan sponsor?
Since there are multiple reasons why a claim may reject, it is best to contact the customer contact center for assistance (800) 247-4526
By accessing that particular claim, a customer service representative can assist the caller with any additional steps that may be needed so the claim will successfully process.
How do I become a participating pharmacy provider?
You may contact our provider relations department at (800) 247-4526
What is the co-payment amount for a specific member?
You should submit the claim through the claims adjudication system to receive the claims response, which will include the amount to collect from the member as well as information about eligibility, drug coverage, pricing, and applicable clinical programs and services. Customer service representatives at the customer contact center cannot always determine accurate co-payment information due to the variables that may impact cost share.