Rx
Programs
Costly new drugs. Inappropriate use. Patient noncompliance.
Use of multiple physicians, multiple pharmacies. Drug interactions.
Unmanaged side effects. Drug expenses rising faster than any
other healthcare cost — with no end in sight.
CBCA
does much more than just manage prescription claims. Our patient-focused
Rx Services team makes life more convenient for plan members
while helping to protect patients and contain costs.
We
offer innovative, flexible Pharmacy Benefits Management plan
designs and customized formularies. Integrated information
systems help coordinate care, identify chronic disease conditions
for early intervention, and process high volumes of Rx claims
per year.
CBCA’s
customized program and integrated services gives members and
the plan single-source convenience with an array of core products
focused on driving down costs:
-
Fully
integrated retail plus mail services with phone and online
ordering.
-
Nationwide
pharmacy network access with over 53,000 independent and
chain pharmacies across the United States. And a convenient
online pharmacy locator, available to participants 24/7.
-
Generic
drug and formulary management.
-
Strict
eligibility verification, benefit design compliance and
price control.
-
Stringent
drug utilization review (DUR).
-
Focused
clinical programs.
-
Flexibility
across the board, from Rx plan design to online CBCA Step
Therapy protocols.
-
Certified
CBCA Pharmacy Technicians and Pharmacists available via
24/7 Rx services hotline.
-
Outstanding
customer service — e.g., Rx hotline phones typically
answered in 30 seconds or less.
-
Proactive
account management for the highest levels of service.
-
CLUES
- clinical & financial analysis
Customized
Rx Benefits
When
it comes to benefits, one size never fits all. So ask about
CBCA FlexDesign™. We’ll analyze your current Rx
program, recommend improvements and offer an exceptional range
of options.
CLUES
Innovation and Results
CBCA’s
member-focused services rely on our unique Clinical Utilization
Evaluation System (CLUES™). It’s among the industry’s
most extensive Drug Utilization Review (DUR) utilities.
CLUES
combines concurrent, retrospective and prospective DUR —
integrating information to serve plan members, CBCA client
companies, healthcare providers and our vendor-partners.
- Concurrent
Review Each time a prescription is filled, CLUES
automatically screens the information for potential drug
related problems. Data on every prescription managed by
CBCA goes into in the HIPAA-compliant CLUES database. We
then use this information to alert providers to any possible
complications such as drug to drug interactions.
- Retrospective
Review CBCA has one of the highest pharmacists-to-members
ratios in the industry. As a result, we provide above-average
service and protection, for example by conducting more extensive,
and more thorough, drug utilization reviews. We use the
findings to improve care, such as by triggering clinical
interventions in high risk cases.
- Prospective
Review Historical CLUES information gives CBCA
pharmacy professionals a huge advantage when offering recommendations
for future member care, cost management and program enhancements.
- Clinical
Reporting CLUES provides ready access to utilization
and financial information about the prescription benefit
plan. CBCA Rx offers hundreds of standardized report formats
and will gladly tailor Rx reporting to your needs and preferences.
Workers
Compensation Programs
CBCA
Rx pioneered PBM workers compensation programs — eliminating
paper claim submissions and enabling program controls such
as contracted pricing.
CBCA
Rx professionals help customize a plan to the sponsor’s
precise requirements. At your option, Rx utilization may be
managed aggressively through claim-specific providers as well
as injury-specific formularies.
To
ensure smooth implementation, we work closely with your plan
administrators, medical manager, and pharmacy providers —
also with case management, initial injury, and long-term injury
claim management professionals.
Learn
more about the power of CBCA Rx — to generate the highest
return on your healthcare management investment. Bottom line
is value, and transparency, which we pass on to our clients
and their members. Since we are not owned or directly affiliated
with any pharmaceutical manufacturer, we are able to act independently
on behalf of our clients in pricing contracts. We’ll
strive to provide you with complete information to determine
the right drug, at the right time, for the right patient.
|
