Services
Overview
Pharmacy Outcomes Specialists offers a variety of services for plan sponsors, retail grocery and pharmacy chains and Medicare Part D sponsors through every phase of the pharmacy benefit program.
CLICK HERE TO SEE A POWER POINT OVERVIEW OF FIRM SERVICES.
CLICK ON EACH SERVICE AREA FOR MORE DETAILS.
For Plan Sponsors (Corporations, Unions, Mid Sized HMOs)
- Requests for Proposals (RFPs) for PBM services
- Contract Review and Analysis
- Renewal Analysis
- Carving Out Pharmacy from the Medical Plan
- Audits of Financial Terms
- Audits of Plan Design
- Audit of Rebate Payments
- Ongoing Monitoring of Financial and Service Performance
- Desk and Onsite Audits of Pharmacies (Retail, Mail, Specialty and Long Term Care pharmacies)
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For Regional Chain Pharmacies and Grocery Stores
- Verification of Reimbursements
- Analysis between PBMs of reimbursement rates
- Verification of MAC pricing
- Verification of transactions by plan
- Dashboard analytics of cost per unit by NDC, comparison of PBMs
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For Medicare Part D Plan Sponsors
- Fraud, Waste and Abuse Programs
- Reporting to CMS
- Auditing of Pharmacies, Physicians, Members and PBMs
- Audit Medicare Part D Programs
- PDE reconciliation
- Medicare Part D Plan Design (TrOOP, LICS)
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Pharmacy Educational Services
For all Plan Sponsors wanting to discuss topical issues and market competitive information in the pharmacy benefits industry without PBM or Pharmaceutical Company “advertising”. Our annual Pharmacy Benefits Academy offers educational courses certified by HRCI through the Midwest Business Group on Health. |
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