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Who We Serve

Partnering with Pharmacies to Deliver Affordable, Quality Care

Pharmacies play a key role in protecting the health of members. Together, we’re transforming how medications are delivered, helping you better serve your patients.

Key Benefits and Advantages for Pharmacy Success

Navitus provides pharmacies with transparent pricing, cost-saving strategies and dedicated support to enhance care delivery and operational efficiency.

Transparency in Pricing

We offer full pricing transparency, allowing pharmacies to understand and benefit directly from savings.

Commitment to Cost Reduction

Navitus is dedicated to lowering prescription costs, enabling you to pass savings on to your patients.

Reliable Support and Resources

With our responsive support and valuable resources, we ensure your pharmacy has everything needed for success.

Partnership-Focused Approach

Navitus values long-term partnerships, working collaboratively to support pharmacies in delivering better care.

Member Satisfaction Rate

Lower Medication Costs

Pass-Through Pricing

Pharmacy FAQs

Expert Answers for Smooth Operations and Patient Care

We value the relationships we’ve built with our pharmacy providers and know how vital it is to have access to the information you need.
For even more information, including the pharmacy handbook and client-specific details, log in to the pharmacy portal.

Prior authorization forms are easily accessed via the Pharmacy Portal.

All prior authorizations are reviewed within two business days of providers submitting all necessary information. Navitus Prior Authorization Specialists will promptly notify providers of any adverse decisions and assist with expediting the patient’s therapy to a formulary drug.

Decisions on which drugs are included or excluded from the Navitus formulary are made by the Navitus Pharmacy & Therapeutics (P&T) Committee, and are based on each drug’s effectiveness, side-effects, interactions and cost/value. The Committee is comprised of prescribers and pharmacists representing a broad range of clinical practice and expertise. The Committee meets quarterly to review new drugs and drug classes, as well as changes in drug indications.

Please allow 2-3 business days for the contract to be sent. If you prefer the contract(s) to be faxed, please let us know at the time of request.

Contact the Pharmacy Network Department for information on joining the Navitus pharmacy network. They can be reached by email at [email protected] or by phone at 608-298-5775.

Please allow 5-7 business days for an independent contract and 7-10 business days for a chain/PSAO contract before adjudicating Navitus claims.

Update pharmacy information with NCPDP. Navitus receives a monthly file from NCPDP and updates our systems accordingly. Submit your update to NCPDP by the 15th of the month in order for it to be updated on the next monthly file load.

Member ID numbers and formats are unique for each group. Please refer to the member ID card for exact format.

Contact the Navitus Customer Care at 844-268-9789 if you receive the following:

  • Missing/Invalid cardholder ID-reject 07
  • Missing/Invalid Date of Birth-reject 09
  • Missing/Invalid Group Number-reject 06
  • Invalid Day Supply-reject 19
  • Refill to Soon- reject code 79
  • Invalid NDC (National Drug Code)-reject 21
  • DUR- Reject 88

Pharmacy Resources

Pharmacy and Practitioner Exclusions

Prescribers and Pharmacies can be deemed ineligible for providing services to government programs like Medicare, Medicaid or even to payers who are participating in government programs.

Prior Authorization Process
Guide

Understand the step-by-step process for prior authorization, ensuring timely medication access for patients and compliance with pharmacy guidelines.

Drug Recall Updates

Stay informed with the latest drug recall information, helping you ensure patient safety and regulatory compliance

Pharmacy Directory Access

Easily find participating pharmacies within our network. View contact details, services, and locations to connect with the pharmacies you need.

pharmacy support, anytime

Contact Navitus: Tailored Support for Pharmacies

At Navitus, we provide dedicated support for pharmacies, 24/7. From prior authorization requests to payment inquiries and credential updates, our team is ready to assist. Explore the contact options below to connect with the right department for your needs.

Phone: 844-268-9789

Or call the number on the back of the member card.

Phone: 844-268-9789

Fax:

  • Commercial: 855-668-8551 (toll free)
  • Medicare: 855-668-8553 (toll free)

U.S. Mail:

Navitus Health Solutions
Attn: Prior Authorizations
1025 West Navitus Dr.
Appleton, WI 54913

Navitus Commercial Members:
844-268-9789

Navitus MedicareRx (PDP):
866-270-3877

Texas Medicaid/CHIP:
877-908-6023

Payment & Remittance

Phone: 608-298-5777

Email: [email protected]

Disputes & Appeals

Phone: 608-298-5775

Email: [email protected]

Verbal complaints may be filed by contacting the 24/7 Pharmacy Help Desk.

Written complaints may be submitted to:

Navitus Health Solutions, LLC 
Pharmacy Network Department 
1025 West Navitus Dr. 
Appleton, WI 54913 

Contact the Provider Services, Contract Team at 608-298-5775 or via email at [email protected].

Ngoc Nguyen, PharmD

The Navitus Managed Care Residency was an awesome experience. The program does a great job of exposing you to different areas of managed care. I have learned so much through the different rotations offered. It also allowed me to be involved in patient care through the unique staffing opportunities. All during residency, I received a lot of support and mentorship, and even after as I continue my career with Navitus. This was one of the best decisions I’ve made.

Ngoc Nguyen, PharmD | Navitus Resident, 2021-2022 | Clinical Operations Pharmacist at Navitus Health Solutions

Musetta A. Steinbach, PharmD

The Navitus residency was an amazing experience. It is incredible to think about how much I learned about managed care and specialty pharmacy over the course of one year… All of our preceptors were knowledgeable, approachable and supportive. During our rotations, we were treated as valued members of the team and given meaningful projects to work on that deepened our knowledge of managed care. I only have great things to say about the Navitus residency!

Musetta A. Steinbach, PharmD | Navitus Resident, 2020-2021 | Drug Information Pharmacist at Navitus Health Solutions

Chelsea Woods, PharmD

Completing my PGY-1 Managed Care residency at Navitus was one of the smartest decisions I have made to-date and has been extremely rewarding for my career thus far. It was an incredible year filled with intriguing and integrative projects, amazing preceptors, and fun memories. I am so grateful that I was able to stay with Navitus post-residency and apply the skills I learned in an exciting and challenging full-time role.

Chelsea Woods, PharmD | Navitus Resident, 2016-2017 | Senior Clinical Account Executive at Navitus Health Solutions

Launch Your Pharmacy Career with the Navitus Residency Program

The Navitus Residency Program is designed to provide aspiring pharmacy professionals with the tools, mentorship, and hands-on experience needed to excel in the dynamic world of pharmacy benefit management. Residents work alongside industry leaders, contribute to innovative projects, and gain comprehensive exposure to clinical, operational, and strategic aspects of the field. This program not only builds expertise but also opens doors to impactful career opportunities.

Interested in joining our Pharmacy Network?
Call us at 866-333-2757

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