Health Insurance Brokers / Consultants/ TPAs
PharmPix is a recent entry into the Pharmacy Benefit Management industry. Our fully customized approach helps reach the level of service that your plan sponsors and beneficiaries expect.
Brokers, TPAs and benefit consultants have leaned on a few, favorite PBMs to serve their clients and impact pharmacy cost containment. The results have been measurable, but there is still plenty of room for improvement. Consolidation in the PBM niche has responded to the needs of the investor community, but in the process, has potentially affected the level of service that plan sponsors and beneficiaries expect.
PharmPix believes that managing drug spending requires a customized approach to the pharmacy delivery equation.
Our business was built on:
- Providing excellent service to our clients, regardless of size. It is a core metric of our success.
- Contracts that are clear and default to our client’s best interests.
- Facilitating best solutions, thereby aligning our mutual financial interests.
- Performance-based fee structure.
- Solid understanding of what matters most in managing the pharmacy benefit and the programs to deliver results.
At PharmPix, we have established a new and innovative adjudication system called the OneArk™ Suite, which offers flexibility, scalability and efficiency within the secure environment required in today’s world of healthcare.
PharmPix has also added key components that are necessary for managing all plan sponsor and beneficiary needs at all levels. The entire suite of services and tools can be purchased as a complete package or individually.
A world-class service company is defined by the ability to facilitate and integrate the best in-class solutions in a hub-like fashion. PharmPix will do all of this and more for your clients.
- Consulting and plan design concepts to meet your needs, such as, value-based programs that are supportive of OTCs and generics
- Data analysis, modeling and reporting to drive employee behavior change
Our OneArk™ System and Suite of service offers:
- Real-time claims adjudication with point-of-sale eligibility validation, online safety and managed care editing capabilities and coordination of benefits
- Detailed claims reconciliation reporting
- Member/Employee portal for retail pharmacy availability, formulary information and access to co-pay/plan design information
- Retail pharmacy contracting R30 & R90 fills
- Pharmacy call center and pharmacy audits
- Medication Therapy Management (MTM) capability at point of sale with a business rules processing engine (BRPS) for push notification via email and text messages
- Mail service options
- Specialty pharmacy options (central fill)
- Prior Authorization (both systemic & live clinical professionals)
- Member services call center
- Clinical program consulting, and Retrospective and Concurrent Drug Utilization Review (DUR)
- Pharmacy and Therapeutics (P&T) Services
- Manufacturer Rebate Contracting
- Manufacturer rebate billing and modeling software