• Formulary Management
  • ​Demand Management
  • Utilization Management

​           - Prospective & Retrospective

  • ​Disease Management

​           - Physician Intervention

  • ​Medication Therapy Management

​           - Adherence Packaging

  • ​Emerging Clinical Programs
  • Outcomes Management
  • ​Treatment Guidelines
  • Specialty Therapy Management

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  • Client Services

            - Benefit Administration​

​            - Eligibility Administration

            - Real Time Reporting

  • ​Pharmacy Network Administration (65,000+)
  • Mail and Specialty Pharmacy
  • ​Claims Adjudication

​           - POS online edits

  • ​Member Services

​           - Education

           - 24/7 Call Center

  • Manufacturer Contracting & Rebate ​Administration

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Administrative


Clinical

                       PBM Services


In six steps, we will design and implement a solution that reduces costs associated with offering a pharmacy benefit. Recent clients have reduced cost as much as 30%!


Step 1: Problem recognition.  We realize that no organization is going to commit funding to anything unless it perceives that there is a problem to solve. In our opinion, a problem may also be an opportunity that goes unresolved due to an inability or unawareness the problem needs solving. Here a decision-maker from your organization participates in a relatively short, but informative executive briefing that is designed to help pinpoint opportunities to permanently eliminate overpayments and reduce costs.


Step 2: Define economic consequences.  If after participation in our executive briefing you believe there is a real problem then together we define the economic consequences. It is practically impossible for any client to make an intelligent decision on whether the problem is worthy of attention until he or she has an idea of how much the problem is costing the company. Without a dollar amount attached, a problem is simply a wish list.


Step 3: Commit funding.  If you recognize that there is a problem and this problem has economic consequences then the next logical step is to commit funding.  This offers you a chance to conduct a side-by-side comparison of each deal involved.  
At this point, you may have an idea of what is needed but have not decided how to determine which product and/or services will provide the best solution.


Step 4: Define decision criteria.  It is only after going through all the prior stages that you begin to define how to fix the problem within your organization. Upon completion of a thorough analysis we will re-price your existing program and share the savings along with all costs associated with participation in our program.


Step 5: Evaluate alternatives.  This is the point at which you

look at what solutions fit within the budget allocated to fix the

problem. If for some reason we cannot help reduce costs or

improve your programs overall performance we will remove

ourselves from consideration.  We will be happy to offer our

expert advice.

Step 6: Select vendor solution.  B
ased upon the commitments

made at all five prior steps, it is at this step that the real decisions

are made.  Since we have worked closely with you on the five

previous steps, we believe that we are more likely to win the final

business because we helped to frame the problem, the budget and 

the criteria.


Our biggest concern, outside of improved patient outcomes and superior service, is that you find a fiduciary PBM provider.  If that is not us then at least we have helped to frame a solution and just maybe you will remember that and contact us sometime in the future.


Click here to inquire about our consulting services.  After the arbitrage has been eliminated from your cost, you will see the financial benefits of a fiduciary solution.  Simply put, a fiduciary is the highest standard of care so why would you settle for less?



Call: (702) 990-3559

Consulting


Every pharmacy benefits plan has a different situation.  Your staff may not have the solution, but generally knows what your company needs as an end result.  TransparentRx offers the skills and resources necessary to understand first, then apply our knowledge and experience to solve complex pharmacy benefits problems.  


While our competitors use buzzwords like transparency, pass-through or cost plus to market services, this often leads to nothing more than excessive remuneration from payers.  Unlike our competitors, we eliminate catch phrases and offer a fiduciary contract which ultimately provides a reduction in both pharmacy and hospital costs.  Our system is unique but simple; we find the issues that are wrong, correct the mistakes and then monitor to insure success.


  • Reverse Auction Specialists
  • Comprehensive Audit
  • Plan Performance Assessment Report
  • Plan Design Audit
  • ​Eligibility Audit
  • Rejected Claims Analysis
  • ​Rebate Audit

​​            -  Verifies contract compliance

  • ​Contract Renegotiation
  • RFP Services
  • ​Performance Guarantee Review
  • Implementation Audit
  • Operational Audit

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