Pharmacy Benefit Management
iMed strategically partners with myMatrixx to provide a seamless solution for a National, and personalized Pharmacy Benefit Management program,(PBM). iMed is your "Single Source Solution" for a nationwide network of over 55,000 retail pharmacies, a myMatrixx-owned mail order Pharmacy, and an information-based clinical pharmacy program. Our services are based on client specific needs and objectives.
iMed's iPharmacy Benefit Management services are described in detail under the following categories:
- • Web portal
- • Pharmacy retail and mail order pharmacy
- • Bill review
- • Clinical pharmacy services
| Features | Benefits |
|---|---|
| Real-time online adjudication | Provides you more control |
| Improved Drug Therapy Management | Increased savings and fraud protection |
| Paperless Pharmacy Solutions | Reduces errors, costs, phone calls |
| Easy-payment for Pharmacy transactions | Reduces check writing and payment processing expenses |
| Increased network utilization | Increased savings through network discounts |
| Provide continual non-network pharmacy bill conversion | Reduces third-party paper bill problems |
| Process all required state reporting | Reduces processing costs |
Reducing Expenses
iPharmacy Benefit Management retail pharmacy network reduces expenses by allowing your patients the convenience of choosing from a network of more than 55,000 pharmacies nationwide, with discounts below the state fee schedule, consolidating the charges to a single tax ID.
iPharmacy Benefit Management delivers services that provide a 360 degree view to both the financial and recovery aspects of each patient. Transactions are integrated in one central place. With 24/7 access, this 360 degree perspective:
- • Provides and/or manages retail prescriptions, home delivery, first fills and paper bills prevents doctor hopping, pharmacy shopping, pharmacy reimbursements, early refills, and over-utilization
- • Prevents fraud and abuse with real-time access to patients’ complete drug history
Streamlining the Process
iMed's iPharamacy Benefit Management helps you eliminate unnecessary processing expenses with our bill review service for all paper pharmacy bills. Bills are reviewed for appropriateness and duplicate billing and adjudicated against in-network claims and formulary. EOBs are generated and returned within 48 hours. Network pharmacies presenting paper bills are contacted for conversion to the iPharmacy Benefit Management online billing system within 24 hours for all future fills. Non-network pharmacies are contacted for network participation.
- • Re-pricing to state fee schedule / U&C or contracted rate
- • Bills accepted in any format: Imaged, Paper or Data File
- • Centralized bill review and pharmacy network allows for penetration analysis and intervention
- • Clients who utilize all aspects of our bill review program can achieve 90 percent utilization
Pay all of your pharmacy transactions with one electronic file. Payment can be made by iPharmacy Benefit Management directly to the pharmacy on your behalf for all paper bills, as well as in-network charges.