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CHILL PILL

A FORMULA FOR
PHARMACY BENEFIT MANAGEMENT

Medicare Part D Operations

Free up your resources with AHS’s Pharmacy Benefit Management (PBM) solutions. Allow us to manage all aspects of your Medicare Part D obligations, enabling you to concentrate on your patients. Our services include staying current with monthly updates to Part D website documents for CMS compliance, monitoring and addressing CMS Part D Reporting requirements, analyzing Part D claims to identify utilization trends, and reviewing monthly Explanation of Benefit Proofs/Fraud and Waste & Abuse reports. Furthermore, we will set and track improvement targets and provide assistance with Part D Coverage Determinations and Redeterminations. Our expertise extends to managing Part D data exchange with PBMs, handling PDEs, Eligibility, and COB seamlessly.

Pharmacy Benefit Management (PBM) – Analysis, Negotiation, and Management

With AHS’s Pharmacy Benefit Management solutions, you’ll enhance your negotiating power to secure optimal pricing for your plans. Our services encompass configuring your pharmacy network, defining your list of covered prescription drugs along with tier structures and copayments, and setting the out-of-pocket expenses for plan members.

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