Quantity vs. Time refers to a process in electronic claims processing where an edit is placed on a claim. This edit prevents the claim from being processed and paid by the health plan if a member is receiving more than the clinically appropriate amount of medication over a stated period of time.

The objective of Quantity vs. Time Limits is to improve the quality of pharmaceutical care in order to obtain appropriate outcomes and to address inappropriate utilization at the time of dispensing to minimize health risks and reduce overall costs.

Click on any of the following to open its associated .pdf file:

Quantity vs. Time Limits Process Flow
This form explains the steps involved in requesting an override after a QVT edit has been placed on a claim for a specific drug.

Override Request Form
The Quantity Override Request Form should be completed by the prescribing physician and submitted to Pharmacy Programs when requesting an override for their patient. If they do not have this form available, we ask that they fax or e-mail the information that is requested on this form.

Quantity Limit Overrride Request Form--Proton Pump Inhibitors
This Quantity Limit Override Request Form serves the same purpose as the general request form provided above except this form is used for override requests specifically for drugs classified as Proton Pump Inhibitors.

QVT Drug List
This drug list provides a listing of all the drug classes and drugs that are subject to quantity vs. time limits.

QVT Brochure
The QVT Brochure provides a brief overview on quantity vs. time limits