Providing Pharmacy Benefit Services Nationwide

WHAT SETS HEALTHPLUS APART FROM THE LARGE CORPORATE PBMS?

Flexible Rx Benefit Designs: Our forte is working closely with the client and/or their broker to create a custom-designed prescription drug plan for employees and their families that is most beneficial and cost efficient for the client and employees. Support call/e-mails from- Client, patient, pharmacy and broker are handled and resolved 98% of the time within 24 hours. Problem solving- We attempt to resolve patient claim adjudication problems while the patient is still at the pharmacy. If a claim is not transmitting we are able to determine why and work with the pharmacy/client to get the claim through (PA, etc) and satisfy the patient needs within minutes versus days. Eligibility updates- Once received, we guarantee to update our system within 24 hours (In actuality, its more like 24 minutes). When a client calls us with a new employee that needs an Rx quickly...the data is actually in the system and the pharmacist called before the patient reaches the pharmacy. Patient Attention- We regularly call individual patients to tell them their medications are ready after resolving a claims processing problem for them. Research and follow-up- On a daily basis we research, follow-up and resolve the following issues: Early refills, Vacation over-rides, members requesting reinstatement, check for inactive/active patients, extend a PA date, copay determinations, rejected claims, correct data...etc. We attempt to resolve all of the above in 24 hours. Access to decision maker(s)/pharmacists- We can make a major decision for most situations usually the same day of the request by consulting our claims processing experts at RESTAT. When a pharmacist's input is needed, we have 9 pharmacists available for consultation.