MC-21 Corporation is the first and only Pharmacy Benefit Management (PBM) company to offer full PBM services in Puerto Rico, now for over seven years. Founded in 1999 with all operations based on the island, MC-21 serves more than two million lives or approximately 53% of the total population of Puerto Rico. The company has successfully and consistently delivered services to both the public and private sectors to clients such as Humana, Triple S, MCS and the government's Health Services Administration (ASES). The company processes an average of 30 million claims per year. Some of the services provided include managing the purchasing, dispensing and reimbursing of prescription drugs, negotiating rebates or discounts from pharmaceutical manufacturers, processing claims for prescription drugs and negotiating price discounts from retail pharmacies. PBMs also develop formularies and manage utilization of drugs through prior authorization or utilization reviews. Headquartered in Caguas, P.R., MC-21 is privately owned and a subsidiary of Orbix Healthcare.
SilverScript, LLC. is a wholly-owned subsidiary of CVS | Caremark. SilverScript Insurance Company is a wholly-owned subsidiary of SilverScript, LLC., offering services as a Medicare Part D Prescription Drug Plan sponsor to their clients' members. SilverScript Insurance Company offers three prescription drug plans: SilverScript, SilverScript Plus and SilverScript Complete.
Partners Rx operates in a full disclosure and open book management environment to ensure that we align our goals and objectives with those of our clients. This openness with our clients has fostered the atmosphere of trust we enjoy today. Our partnership strategy reduces the complexity of prescription benefit management. It encourages the exchange of ideas to solve problems together. Other PBMs may sell value through high discounts, low administrative fees, low dispense fees and large rebate payments. We see value in competitive pricing strategies and rebates on appropriate medications, but at PRx , we focus on drug mix, the greatest slice of the drug cost pie by far at 95%. The question we ask ourselves everyday is how can we manage the drug mix better to further our clients' goal of achieving the Lowest Total Cost? Partners Rx has demonstrated that its strategy has proven to be successful delivering trends in total pharmacy spend (including utilization) at 4.5% and 2.2% for 2004 and 2005 respectively on our entire book of business.
MedMetrics Health Partners is a non-profit, full-service PBM located in Worcester, Massachusetts, and is affiliated with the University of Massachusetts Medical School. As one of the nation's only non-profit PBMs, MedMetrics features a business model which differs from that of the traditional PBM by providing true net cost drug management with full transparency in all financial transactions and data reporting. Unique among PBMs is MedMetrics' association with a major medical school which affords direct access to expert formulary and clinical guidance and academically rigorous, evidence-based clinical programming support.
RESTAT is one of the very first prescription benefit managers (PBM) to offer a "flexible" benefit plan, designed to offer clients cost containment solutions. Since 1985, we have grown to be a well-trusted industry leader providing a range of PBM services to about three million covered lives. Our clients include insurance companies, managed health care organizations, third-party administrators, pharmacy provider groups, private label marketers, and self-funded employers. We enjoy the relationship we have with our clients. This is why we have carefully managed our growth to ensure that we will not only continue to listen to our clients' prescription card needs ... but also tailor solutions to fit those needs. "At RESTAT our philosophy is 'the customer comes first.' It's a commitment we made when we started the company and it's one we've remained true to ever since. In fact, putting the customer first and foremost is behind everything we do to maximize health benefit value through evolving technology, innovation, and service."
http://www.corporatepharmacy.com
Corporate Pharmacy Services is a pharmacy benefits management company incorporated in the state of Alabama in 1990 that currently serves 307 companies in 28 states. Clients include employers, insurance companies, associations, third party administrators, cities and municipalities and managed care organizations. CPS fills maintenance prescriptions for long-term injuries from its mail order facility located in Gadsden, Alabama. The mail order division specializes in the home delivery of medications, medical equipment and supplies to workers' compensation patients and the chronically ill. Short term prescriptions can be filled at over 50,000 pharmacies nationwide using CPS' paperless or Rx card program. These programs capture "first fill" of a prescription at a negotiated rate that is always below state fee schedules. Data collection, with recommendations being made to the client based on the analysis of the data, is yet another component of our management program. A vast array of management reports helps detect areas of current program inefficiencies. Our professional staff then makes recommendations and gives you the tools to improve your program and thereby lower your cost. CPS' innovative approach to workers' compensation prescription drug management has led to savings of 21% to 54% off current billings for the companies we serve. Never has a company saved less than 20% after fully implementing our program! If you're ready to save at least 20% off your current prescription drug bill while freeing your adjustors from administering, the pharmacy program then why not contact us today!
LDI is a pharmacy benefit management company (PBM). LDI administers the prescription programs of health insurance plans on behalf of health maintenance organizations (HMO's), indemnity insurers, and self-insured employers. LDI Pharmacy Benefit Management was founded in 1964 and has earned the reputation of an innovator in the pharmaceutical industry. We were one of the first independent companies to offer discounted prescription service, modified unit dose medications for long term care patients, tracking documentation to ensure proper utilization of medication for patient care, and managed care strategies for pharmacy benefits. Contact an LDI Account Executive Today: Customized Plan Designs incorporating clients needs Aggressive Formulary Management Formulary Selection Commication with Benefit Managers to monitor plan success Call 1-800-652-9550 or locally at 314-652-2121.
PrescriptiCare was founded in 1998 in Kansas City, and has since become a leading regional provider of specialty pharmacy prescriptions and services. Being locally owned and operated, we are able to provide you with benefits not found at traditional pharmacies. We are committed to therapy related services and programs designed for the needs of patients with chronic conditions. Our company offers its clients the highest level of service, patient education, reimbursement assistance and timely delivery of specialty medication. We are committed to provide you with: Ongoing patient support,24 hour service, 365 days per year Unparalleled service and quality care Insurance assistance Convenient/confidential delivery to you home or location of choice
Health Information Designs, Inc. was founded in 1976 and is incorporated as a C Corporation in the State of Delaware. HID's initial mission was to market drug utilization review (DUR) services nationally and since its founding it has provided DUR services for clients in approximately two-thirds of the various U.S. states. HID was sold to Value Health, Inc. in 1987 and in turn was sold to Health Data, Inc. in 1997.
Avia Partners, Inc. is a full service clinical pharmacy benefit management company, established in 1992. A subsidiary of Safeway Inc. Avia Partners provides unique services that enhance our clients' ability to manage waste and improve the quality of health care. Avia Partners trend management expertise allows us to develop custom and comprehensive programs to meet the goals of our clients and their beneficiaries. Our goal is to provide lower costs while delivering excellent client service.
NMHCRX provides PBM services for corporations, unions, health maintenance organizations, third party administrators and local governments. Through its clinical programs, value-added offerings and advanced information technology systems, NMHCRX can provide high quality cost-effective management of pharmacy benefits.
WHI provides its clients with innovative and comprehensive pharmacy benefit management services, state-of-the-art mail service pharmacy, an extensive range of home care products and services, clinical services, and the latest in specialty pharmacy products and services. WHI's business philosophy centers around the belief that overall health is achieved through integrated and comprehensive pharmacy benefit services that work successfully together.
Direct Pharmacy Service is a prescription benefit services company specializing in mail order pharmacy. We can also provide pharmacy benefits management (PBM) services through partnership agreements. Our mission is to deliver prescription drug benefits through tailored solutions and exceptional care to our clients with efficiency, accuracy and excellence.
Founded in 1997, Total Script is a pharmacy benefit management company gaining national recognition for its prescription discount structure, its reputation for premium customer service, and its success in implementing winning solutions for its clients. Total Script's executive management team used its nearly sixty years of industry experience to develop a straight-forward business model that focuses on delivering maximum value to the client. Studies show that drug benefits now represent 22% of most employers' healthcare costs, and this expenditure may reach 35% within five years. It is becoming increasingly vital that plan sponsors fully understand their prescription drug pricing structure and how the prescription benefit industry operates. Unfortunately, removing the complexity of understanding your plan and exactly what you are paying for has not coincided with traditional PBM providers. Total Script recognized this, thus a business model was developed that focuses on educating the client and delivering a plan which controls costs. Total Script offers a full line of services to self-insured and insured clients, brokers and consultants, third party administrators (TPAs), insurance companies and HMOs. Total Script's complete range of innovative pharmaceutical, clinical and administrative programs and services include: Excellent Customer Service We understand that challenges will arise due to the sheer volume of prescription claims processed, thus Total Script has made a commitment to solve real problems in real time with real people; your members will not be confronted with a never-ending maze of teleprompter options in search of a live customer service representative.
http://www.medtrakservices.com
MedTrak is an independently owned pharmacy benefit management company, free of ownership by a drug manufacturer, mail pharmacy, retail pharmacy or insurance company. This independent thinking enables MedTrak to offer Plan Sponsors and Plan Members prescription benefits and services that have the best interests of both in mind. The cornerstone of our business is our personal commitment to our customers to meet their needs. From our Customer Service department to our Account Managers to our CEO, our commitment to service is from top to bottom and throughout our organization.
R/xx Pharmacy Solutions, Inc. is one of the few truly independent "managed care" oriented pharmacy benefit management companies in the marketplace today. As a wholly owned subsidiary of a privately held managed care company founded in 1983, R/xx has perfected the managed case methods necessary to control pharmacy benefit costs, provide early detection of potential costly medical problems and at the same time, present this information in comprehensive and easily readable reports. R/xx Pharmacy Solutions, Inc. focuses on an alliance between the client, the member, the pharmacy and the prescribing physician. We believe with the involvement of all principal parties working together, that we are able to provide substantial prescription drug benefits and contain overall utilization costs. R/xx Pharmacy Solutions, Inc. believes that the utilization of prescription drugs is only a slice of the total healthcare continuum that needs to be integrated into a total medical care management process. Consequently, we work closely with our clients medical management team. R/xx Pharmacy Solutions, Inc. is a national program that offers flexible plan design features enabling you to reach your overall program goals. We work with you in designing a unique plan and approach including a drug formulary customized to meet your individual prescription needs. Pharmacy Services include: A national network of 50,000 pharmacy providers including most major retail chains and national independent pharmacies. Real-time electronic prescription claim processing. Mail-order option to allow substantial savings on maintenance drugs. Prospective and Concurrent online Drug Utilization Review (DUR). Comprehensive management reports provided at no additional fee. An experienced customer service "Help Desk" for members, physicians and pharmacy providers. Retrospective drug utilization review to report any potential problems to be addressed. Clinical intervention and education with healthcare providers. Informational material provided to both benefit managers and members. To support our customers we provide: Standard Monthly Reports Package Monthly Executive Summary Concurrent, Retrospective and Prospective Drug Utilization Review Programs Open/Closed Formulary Management Web site for Health Information and Medication Refills Network Pharmacy Listing Physician Profiling and Intervention Disease Management Programs National Pharmacy Network Management Eligibility Maintenance Pharmacy Connectivity Links Plan Administration Information Claim Forms and Reimbursement for Out-Of-Network Providers Assignment of Benefits On-line Utilization Review Services Prior Authorization Processes ID Card Production Privacy Policy
ProAct maintains a therapeutic formulary for client use. However, with our flexibility, the client's specific needs and requests can always be met concerning benefit design and formulary management. ProAct Pharmacy Services, Inc. is a full service prescription benefit management company, providing the latest in pharmacy benefit management technology while also providing excellent local client and customer service. To request more information on ProAct's services please send an email to: Todd Menard
AmeriScript is a nationally recognized full service Prescription Benefit Manager (PBM) located in Stow, Ohio. Since its establishment in 1986, AmeriScript has grown steadily by providing a long-term commitment to each of our clients. AmeriScript is best characterized as an organization whose paramount concerns are for improving patient health and providing outstanding member service and account management. AmeriScript is a wholly owned subsidiary of Interplan Health Group (IHG), a health service company that specializes in providing Payors with network and state-of-the-art managed care services. Interplan is a healthcare network offering Preferred Provider Organization (PPO), Exclusive Provider Organization (EPO) and Pharmacy Benefit Management (PBM) programs.
SUNRx (the "Company") is a privately owned and independently operated C Corporation located in Cherry Hill, New Jersey. SUNRx launched in August 2001 as a Client Advocate consultancy, auditing PBMs and prescription plans. Based upon its findings and in response to clients' concerns over the integrity and spiraling program costs of their incumbent PBMs, SUNRx, through its founder Gerard J. Ferro and Christine Serenelli developed an industry revolutionizing solutions built upon fiduciary responsibility, client advocacy, integrity, full disclosure and 100% pass through of rebates and market share allowances. SUNRx was incorporated in January 2002 and since that time has dedicated its efforts to developing the Nations first proprietary Prescription Benefit Administrative Advocate service designed to reduce spiraling prescription plan costs. Through use of its proprietary software, national retail pharmacy network of over 60,000 pharmacies, its strategic mail order pharmacies, and specialty pharmacy partnerships, SUNRx can provide prescription benefit administration services to individuals, Managed Care Organizations, self-insured employers, insurance companies, unions, Medicaid and Medicare managed care plans, Federal Employees Health Benefit Programs and other Federal, state and local governmental entities. As the first Pharmacy Benefit Administrator in the United States, with over 60 years of management experience in healthcare, pharmaceutical and prescription plan design, implementations and service, SUNRx advocates true TRANSPARENT Prescription Plan Administration. We offer industry revolutionizing Point of Sale technology, Maintenance Medication programs at retail and mail order and incentivized generic offerings that are all designed to maximize safety, efficacy and contain costs. Through our Integrity Based Program, our role as a Client Advocate, and as a contractual Fiduciary for its Clients, SUNRx has experienced growth exceeding 2000% since 2001. We have been named the 19th fastest growing company in the United States by Entrepreneur Magazine in June 2005, we are also named the #1 fastest growing company in the Philadelphia region by The Philadelphia Business Journal in October 2005 and we will continue to bring unprecedented discounts and savings to the Prescription Benefit market.
Innoviant manages your group prescription program by taking responsibility for group set-up, benefit structure, preferred products list management and customer service. We provide cost saving electronic claims processing services. We also have our own extensive national pharmacy network and offer retail and mail order services at reduced rates. Innoviant makes it convenient and affordable to obtain prescriptions. Innoviant offers our members the advantages of discounted pricing on prescription products and ease of processing. The electronic claims system applies the discounted cost directly to the product purchased when the Innoviant card is presented at a participating pharmacy. In addition, Innoviant has a comprehensive preferred products list that promotes additional cost savings to the sponsors and their members.
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