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Pharmacy

Arkansas Total Care provides high quality and cost-effective drug therapy to our members. Arkansas Total Care covers prescription medications and some over-the-counter medications approved by providers. The pharmacy program does not cover all medications. Some medications need prior authorization, some may have limitations.

Pharmacy Benefit Manager (PBM): Envolve Pharmacy Solutions

Envolve Pharmacy Solutions, Arkansas Total Care's PBM administers the medication prior authorization process. 

Click on the link below to access Arkansas PDL/PASSE Drug Formulary including:

  • The PASSE maximum allowable cost (MAC) pricing
  • Provider guideline for pharmacy claims submission
    • Payer sheet
    • Paper claim submission requirements
    • Compound prescription requirements
    • Prospective DUR response requirements

For questions, please contact Envolve Pharmacy Solutions 24 hours a day, 7 days a week, at (800) 460-8988. 

Envolve Pharmacy Solutions Portal

Here are more resources if you cannot access the Envolve Pharmacy Solutions Portal: