Pharmacy Solutions
Our PBM is tailored for workers’ compensation and auto casualty. 100% of our focus, investment, and expertise supports these customers in contrast to other PBMs who offer commercial health programs. Our solution features clinical management, innovative and unique technology, full integration with other solutions, and incredible service to deliver optimal outcomes.
Patient Inquiries:
The Power of a Complete Solution
Traditional PBMs are only able to provide clinical review on claims submitted through network pharmacies. We are the only PBM solution that provides the same clinical oversight to both in and out-of-network scripts through our patented technology.
Features and Benefits
- Clinical oversight on all prescriptions
- Increased savings through patented out-of-network solution
- Holistic view of PBM, bill review, clinical, and claims system data
- Ability to influence provider dispensing behavior through network relationships
- Real-time smart routing to adjusters, pharmacists, and case managers to ensure the right claim is handled by the right resource at the right time
- Risk scoring to flag high-risk, high dollar cases
- In-depth reporting specific to your program
- Early intervention programs
- Actionable insight tools for decision support
Integration Provides Double Digit Savings
"Having the bill review and ScriptAdvisor programs integrated significantly improves ease of use"
—VP of Claim Operations, Regional WC Carrier
Customer Service
- Dedicated Account Management
- 24/7 Client Service Team
- Follow Through on All Calls
- 98% Inquiries Resolved on First Call
- 27 Second Average Answer Time
Comprehensive Clinical Resources
- Dedicated Client Specific Pharmacist
- Extensive Fraud, Waste and Abuse Monitoring and Intervention
- Custom Formulary Management
- Automated Monitoring and Risk Scoring
- Clinical Management and Intervention
- Opioid Management Programs
Expansive Pharmacy Network
- 73,000 National Retail Pharmacies
- No Risk First Fill Program
- Point-of-sale Controls
- Mail Order Pharmacy
- Extended Specialty Networks
Advanced Technology
- Innovative Web-based Platform
- Pre-built Bill Review, Clinical, and Claim System Integration
- Customizable and Flexible Workflow and Controls
- Real-Time Data Analytics & Reporting
- Accelerated and Streamlined Implementation
ScriptAdvisor
PBM built exclusively for the workers' compensation and auto casualty industries with customer and member web portals.
Ask The Pharmacist
Our clinical team is ready to answer your pressing questions about specific claims and offer clinical expertise to help you make decisions regarding drug-related issues.
Pharmacy 101
Workers' compensation pharmacy benefit management can be complex, especially when understanding key terms.
Enlytening Conversations
Hear what two of our PharmDs have to say about pressing pharmacy industry issues for workers’ comp payers.
Pharmacy Insights
There is always something to talk about when it comes to workers’ comp and auto pharmacy. To learn more, visit our pharmacy insights page.
Learn More
Navigate Next Now
Our extensive pharmacy program delivers the industry's most comprehensive PBM solution so that you, your team, and your program can navigate what's next with success. Contact us to find out what's next for you. For patient inquiries, please call 866.549.1552.