Managed Care/Health Plans/PBMs
Commercial
Health Exchange Plans
Medicaid
Medicare
We are familiar with all lines of business. We understand the regulatory requirements on a Federal and State level and will make sure you are prepared for audits.
Formulary Planning Guidance
If you’re looking to make changes on your formulary on 1/1 or 7/1, then you have come to the right place. We can show you the tricks of the trade to save your institution money while taking care of your members.
Mock Audits
We can audit your organization prior to the regulatory bodies showing up at your doorstep. We will assure you that your organization runs quality assurance and compliance reports throughout the year.
NCQA Mock Audit
Ask us about NCQA Mock Audits! We have been there and done that. Please make sure to ask how you can prepare your pharmacy department with member profiles for audits by NCQA. We can guide your organization for both initial accreditation and renewal.
Rebates
Not so sure how to negotiate with manufacturers about rebates? You have come to right place! We can work with PBMs and manufacturers and make sure you are obtaining the best rebates in the market for medications to be listed on your formulary.
Utilization Management
We are experts in prior authorizations, step therapy, quantity limitations and buy-and-bill. We can guide your organization to integrate technologies to streamline prior authorizations, so your members can be taken care of with the utmost guidance.