It might seem like Alphabet Soup, but knowing what NDC and J-Code means is an absolute must. Essentially, both are used to determine how your medical procedures or medications are billed to your health insurance. However, there are significant differences …

You’re probably getting ready to review your pharmacy benefits plan and how much you’re spending. How much you spend depends on your PBM contract, which can be anywhere from radically transparent to opaque. Consider these three tips to help lower …

If you’re managing a self-funded healthcare plan in 2021, chances are you know about specialty medications and how they can devastate a pharmacy benefit budget. Specialty drugs are becoming more common, so your organization needs to have a plan for …

Chances are if you manage a self-funded health plan, you know how important specialty meds are to your overall costs. The complex administration of these high-costs drugs can be intimidating. But as an HR administrator, you shouldn’t be as there’s …

Less is more, right? When it comes to pharmacy benefits, this is absolutely applicable. It’s called Lesser of Language, or language in your PBM contract that instructs PBMs must use the lowest price of a drug on the market when …

Have you ever caught yourself forgetting what a certain acronym stands for? There’s so many in the world that we’re bound to forget one on occasion. It’s the same with the acronyms in pharmacy benefits.

Does the number 835 mean anything to you? It should. You need to make sure there’s language in your audit rights with your PBM contract that allows access to the 835 file.

You know when your prescription drug is dispensed at the counter, it is paid usually in the form of a co-pay. You also understand the PBM determines how much you pay the pharmacy. But what do those pieces mean to …

A PBM offer that offers an administrative fee of just $1 or no fee at all may sound good, right? Think again. Apex Executive Advisor Scott Long will explain why you should run the other way if you receive a …

Traditional PBMs want to give clients as much exposure to pharmacies as possible. Why? They’ll have endless opportunities to charge you one price, and a pharmacy a lesser price. Apex Executive Advisor Scott Long will detail how you can take …

Pharmacy benefit managers only provide the level of transparency asked for by customers. That means some clients could have unnecessary healthcare costs, gaps in coverage and unused services. Apex Executive Advisor will explain how Apex can find those gaps and …

You don’t have to be a Fortune 500 company to receive a high-level of transparency from your PBM. Apex Executive Advisor Scott Long details how Apex can get you that same kind of transparency not just on drug costs, but …