A FORMULA FOR
PHARMACY CLAIM EFFICIENCY.
Let us manage your drug formulary. Our team has negotiation power to get the best pricing for you. We will configure your pharmacy network, determine your list of covered prescription drugs including tier and copay and establish how much plan members pay for out of pocket.
Part D Oversight
Free up your resources by letting us handle all your part D tasks. We will take care of monthly updates to Part D website documents for CMS compliance, monitor and respond to CMS Part D Reporting, analyze Part D claims for utilization trends, review monthly Explanation of Benefit proofs/Fraud, Waste & Abuse reports, and improvement targets and support Part D Coverage Determinations and Redeterminations for you. We also handle the Part D data exchange with PBM including PDEs, Eligibility and COB.