Medicare Part D Report to Member (RTM)

HMSA Medicare Part D members receive a monthly Part D Explanation of Benefits (EOB) report, which is their Report to Member (RTM) Monthly Prescription Drug Summary on drug services received. The Part D EOB provides members with detailed information about their drug claims, such as:

• member’s name
• date filled
• pharmacy name
• name of drug
• days supply
• prescription number
• retail cost
• member's out-of-pocket cost
• member's benefit (reflected under plan payment)

If applicable, it will also list a lower cost alternative for each prescribed drug.
The Part D EOB will also detail the drug payment stage the member is in which is dependent on their specific plan and individual utilization. If applicable, it will list a lower cost alternative for each prescribed drug as well.

Pharmacies should ensure that they submit complete and accurate information on each prescription claim for HMSA members. Inaccurate information generates inappropriate claims and potential member inquiries regarding the claims as reported on the EOB. Members may seek assistance from the dispensing pharmacy to answer these types of questions.

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