There are many details to consider when selecting your pharmacy benefit manager (PBM) and plan, including everything from flexibility in plan design to how processes ensure a smooth implementation.
When creating a prescription plan for your employees, it’s important to consider which prescription drugs will be covered, what tiers or categories they fall under, and the flexibility your employees will have when getting their prescriptions filled.
When it comes to ensuring a successful implementation, the processes in place at the PBM can have a significant impact. Here are a few ways our processes help our clients experience a smooth transition of their prescription benefits plan.
Quality control during onboarding to ensure accurate processing
At MaxCare, we use a three-step quality control process for onboarding new clients that helps ensure proper account setup and accurate processing. Each of our clients is assigned a dedicated implementation manager who guides them through this process.
- The implementation manager works with the client to create and complete the initial program design.
- Program design is reviewed and approved by the client to ensure accuracy.
- Program design is thoroughly tested prior to go-live date to ensure claims are processed correctly.
As the group go-live begins, the implantation manager transitions to an account manager and is the client’s ongoing primary point of contact. They monitor client accounts and as each account evolves, they may recommend account changes that could minimize prescription drug spending.
Quarterly reports plus interim alerts to monitor total spend
Another piece of our process is providing quarterly reports to our clients. We also regularly monitor the plan and provide alerts if there is any activity that needs attention.
Our clients find the quarterly reports helpful, as it allows them to monitor prescription drug spend while also evaluating the overall plan cost.
One of the main reasons employers opt for a self-insured benefit model is to save money, so it’s important that we provide our clients with the data they need to make sure those cost savings are happening.
Our commitment to clients
We are committed to a seamless transition for our clients and their members. Our goal is to help your business offer a cost-effective prescription benefit for your employees while ensuring the plan meets their needs.
Are you ready to take control of your prescription benefit costs? Contact MaxCare today to get started.