What We Can Do for You
Highly Customizable Plan Designs
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Multi-layered Network Design
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Drug, Formulary and MAC Management
Parallel Adjudication
Member and Eligibility Tools
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Claims and Accumulators
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Data, Insights and Reporting
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Accounts Payable/Accounts Receivable
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3-Pronged Data Integration Approach (UI, API, DB)
Web-based with Intuitive UX/UI
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Screens Designed With the Support Teams in Mind
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Automated File Loading and Transferring
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Customer 360 Call Assist
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Fraud Waste and Abuse Monitoring
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Accounts Payable/Accounts Receivable
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Retail Network Rental
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Underwriting Support
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MAC Management
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Rebate Management
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Copay Assistance
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PBM Consulting Services
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Plan Design Services
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Claim Routing Services
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Customer 360 Call Assist
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API Connectivity
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TPA Connectivity – Eligibility and Accumulator Expertise
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Member Portal
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Claims Adjudication
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Mail and Specialty Pharmacy
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Formulary Management
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Clinical Pharmacists
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Prior Authorization Criteria
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Automated Prior Authorizations
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CoverMyMeds and Surescripts
