Rx Solutions

RxConnection offers a total package for managing your company’s prescription benefit.

Total Risk Management

In today’s evolving world of prescription benefit management, focusing only on the financial aspect will put your company at a disadvantage. Pricing and rebates are no longer the only way to achieve the best savings for your prescription benefit plan. We believe the bigger picture takes a multi-faceted approach and we want to educate you every step of the way to make informed choices. RxConnection aligns multiple facets of your benefit including Clinical, Financial and Service to ensure that any risk is managed on all fronts. These three critical pieces are part of RxConnection’s Total Risk Management service offering which utilizes a holistic approach to best manage your prescription benefit.

RxConnection aligns multiple facets of your benefit including Clinical, Financial and Service to ensure that any risk is managed on all fronts.

Clinical

Clinical oversight is critical to reduce waste and drive appropriate utilization. We will proactively review claims data to identify any emerging trends or wasteful spend. Here are some of the ways that we approach managing your benefit from a clinical perspective:

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  • Clinical resource for routine decision support
  • Perform Rx claims diagnostics
  • Implement appropriate formulary and clinical rules
  • Remove non-essential, wasteful medications
  • Audit specialty prior authorization approvals
  • Educate on strategic benefit design and PBM program offerings
  • Review plan performance and future strategies

Financial

Pricing, performance and auditing are an essential part of your overall prescription benefit package. Our team will hold the PBM accountable to deliver the pricing and guarantees outlined in the RFP process. Here are some of the ways that we approach managing your benefit from a financial perspective:

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  • Review performance scorecards
  • Audit claims annually to hold the PBM accountable
  • Provide a warehouse for claims data
  • Negotiate PBM renewals
  • Ensure contract compliance

Service

Managing optimal service for your employees and ensuring they receive appropriate communication is key. We partner with our clients and the PBM to ensure that employees are receiving superior service and understand the transition process. Here are some of the ways that we approach managing your benefit from a service perspective:

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  • Provide 100% initial and ongoing implementation support
  • Hold the PBM accountable for service
  • Oversee the patient experience
  • Manage the disruption process and communications
  • Resolve conflicts and service recovery
  • Audit service-based performance guarantees

Learn how our team can help you with your pharmacy benefit solutions.