September 20, 2021

Zooming in on Transparency in Pharmacy Benefits

On This Episode:

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 between the two and how they are brought to the market.

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Pharmacy Benefits Consulting

Save 30% to 50% on your pharmacy benefits programs

Uncover Found Revenue Through Savings

Contract Health Assessments

Our CPBS team will review your PBM contract to assess its strength and transparency and assign a score from A to C. With your contract health score in hand, our team audits your entire Rx benefits program to identify cost-saving opportunities.

Sourcing & Contracting

Once the contract assessment is completed and action plan determined, the team sources better pricing from the current or new PBM companies. The team also ensures the commitments made are written into a strong, transparent PBM contract.

Implementation

Working with the PBM, third-party administrator and your team, we will guide your plan implementation from set-up to go-live. We work with you and your employees to manage the transition and minimize any potential disruption.

Customized Monitoring

Monitoring is a crucial tool to ensure you get what you pay for. We offer a range of customized reporting, analysis, market check/monitoring and audit services to make sure the pricing and performance of your pharmacy benefits remain aligned with the contract terms.

Scott Long

Authored By

Scott Long, CPBS, CHVP

Executive Advisor

 

Meet Scott