What is a Payment Determination or reimbursement?
A payment determination is any determination (i.e., an approval or denial) made by MCS, with respect to whether reimburse you for the money or part of the money you already paid for a medication. That is commonly known as a Direct Member Reimbursement (DMR).
How can you request a Payment Determination?
You or your representative should mail your written request to the address below:
MCS Advantage, Inc.Attention: Pharmacy DepartmentPO BOX 191720San Juan, PR 00919-1720
If you need information or help, you can call us at:
Reimbursement Requests (about your Part D prescription drugs)
WRITEMCS Advantage, Inc.Attention: Pharmacy DepartmentPO BOX 191720San Juan, PR 00919-1720
FAX1-866-763-9097
CALL Our service hours are Monday to Sunday from 8:00 a.m. at 8:00 p.m. from October 1 to March 31. Our hours of operation from April 1 to September 30 are Monday through Friday 8:00 a.m. to 8:00 p.m. and Saturday from 8:00 a.m. to 4:30 p.m.