What the.. GoodRx

So.. obviously everyone knows GoodRx charges processing fee etc etc. Punished for selling data etc.

Today I learned something new.

Caremark will, under certain circumstances re-route a claim automatically and behind the scenes to GoodRx. We had a claim that we couldn't understand why Medicaid was rejecting cob with. When we look at the caremark commercial portion of the claim under 'network' it shows GDRX instead of the normal caremark network.

Assumingly they must have verbiage in their patient contracts to allow this to happen, or else that would seem illegal.

Sucks for patient standpoint, they ended up with a extra service charge that caremark/GoodRx added to the patient payment (we didn't) and Medicaid won't cover any of the script now (won't accept not being secondary). All without most patients having any idea

Anywho, just a weird thing I never realized. I've seen discounted/contracted pricing from pbms when they don't cover something, but never a direct/hidden route straight to goodrx