Pharmacy Benefit Managers (PBM)

Our PBM software provides a highly customizable solution that can handle an unlimited number of coverage plans. While our system has been configured to address virtually every benefit management function imaginable, below are the core features of our system:

Pharmacy Benefit Core Features

On-line Adjudication Processing of claim and reversal requests from in-house pharmacy systems, large volume chains, and independent network providers
On-line Maintenance functions that allow user to define and change Formulary and Coverage structure as necessary.
On-line linkage to centrally maintained membership and eligibility files
DUR and Rebate Management functionality
On-line Help desk functions that include issuance of Prior Approvals and rejection overrides
Processing of Manually submitted and Indemnity claims
AD HOC reporting
Payment processing that is linked to corporate A/P systems.
Weekly Price and formulary file update

In addition to the extensive functionality provided by our system, we take pride in our ability to meet your needs by integrating with your existing systems, cost-effectively expanding our system to meet your expanding business needs, and providing a high level of service to ensure your business operates smoothly and profitably.

To order or to get more information, Call 800-835-6787 or Click to Email