As a team of benefits strategists, we work hard every day to make sure we’re exceeding client expectations and providing the most innovative and value-generating plan designs and advisory services.
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.
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.
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.
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.