Who We Service
RxLogic's technology solutions successfully address the overall market challenges that confront every healthcare stakeholder in the pharmacy benefit space: rising costs of drugs – especially specialty pharmaceuticals and treatment therapies – along with increasingly complex regulatory compliance issues and transparency requirements. Each market segment has defined, nuanced needs that require tailored technology solutions that are flexible and adaptable to specific business environments. RxLogic understands these distinctions and designs configurable, data-driven SaaS-enabled platforms that conform to the priorities of every organization we serve. Our dedication to personalized, ongoing service is a company hallmark.
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PBMs
Pharmacy Benefit Managers (PBMs) are under increasing pressure from federal and state governments, patients and employers that are scrutinizing PBM practices for transparency, data accuracy and the impact of these issues on drug costs, patient access, prior authorizations and formulary considerations. RxLogic is highly sensitive to the need for PBMs to respond rapidly to these industry changes, remain competitive and maintain uninterrupted service for their clients. As the technology backbone for innovative and alternative PBMs, we are committed to providing data-driven insights that enable organizations to distinguish themselves in the marketplace.
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Health Plans
With network challenges, employers look to Health Plans to provide data-based strategies and analytics for optimizing cost-containment programs and managing high-cost healthcare claims. In this highly pressurized, competitive marketplace, RxLogic technology solutions are helping organizations to evolve from simple administrators into strategic allies, giving plans full control over program design and operations with seamless migration that ensures accuracy without disrupting members or existing processes.
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TPAs
Third-Party Administrators (TPAs) face increasing demands to deliver data-driven insights and cost-containment strategies for self-insured employers. RxLogic empowers TPAs with advanced technology solutions that provide full control over pharmacy benefit program design and operations, enabling seamless migration and real-time analytics without disrupting member services or existing workflows.
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Self-Insured
Volatile healthcare expenditures are becoming the norm, leading to significant financial unpredictability and administrative complexity for self-insured employers. Plan sponsors face broad fiduciary responsibilities for claims processing and must navigate a complex landscape of regulations related to price transparency. RxLogic recognizes these challenges and provides technology solutions that allow employers to gain full control over their benefits – quickly and confidently – to optimize financial plan performance and deliver the best value for their members.
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Hospice/Long-Term Care
Managing high-risk medications and preventing misuse are priority concerns in hospice and long-term care facility settings. These issues are complicated by factors unique to this patient population, such as polypharmacy and end-of-life care considerations. Operational pressures such as medication diversion in home hospice settings, medication errors and escalating drug costs contribute to the nuanced challenges of end-of-life or long-term care. RxLogic technology solutions respond to these complexities, offering hospice-specific billing logic, real-time claims adjudication and automated exception workflows that reduce manual effort. Transitioning is simple and supported, allowing staff to focus on patient care rather than administrative tasks.
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Grocery/Pharmacy Chains
Declining reimbursement rates from pharmacy benefit managers (PBMs), decreased profitability from generic drugs and increasing operational costs continue to challenge retail chains. RxLogic appreciates and responds to these issues, enabling retail chains to gain more control over their pharmacy benefits, contend with uneven rebate tracking, limited claims visibility and reliance on outside PBMs. Technology solutions remain compatible with existing networks, ensuring that onboarding is seamless and allows chains to take control without operational disruption.
Learn More >Pharmacies
Independent and chain pharmacies face mounting pressures from DIR fees, reimbursement cuts and complex billing requirements. RxLogic provides technology solutions that give pharmacies greater control over claims processing, network participation and financial performance, helping them navigate PBM relationships while maintaining profitability and delivering quality patient care.
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Veterinarians
Like in human healthcare, veterinary medicine is seeing significant increases in the cost of drugs and other medical supplies due to inflation, manufacturer pricing changes and supply chain disruptions. The cost pressures on veterinary drugs create significant challenges for both pet owners and benefit program providers, such as pet insurance companies. Navigating deductibles and caps on reimbursement can be challenging to pet benefit programs, forcing them to deal with fragmented systems and limited visibility into claims and plan performance. RxLogic understands this specialized market and strives to enable scalable operations that provide a seamless experience for providers and pet owners, helping programs to improve service for all stakeholders.
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Government
Cost control, access, equity and regulation remain challenging to government-sponsored pharmacy programs that must manage complex populations with strict compliance, reporting and audit requirements. RxLogic's secure, independent adjudication platform with configurable plan tools and real-time claims processing technology solutions answer the need for greater efficiencies and broader oversight that deliver full audit visibility. Implementation is straightforward, helping agencies modernize drug benefits rapidly and deliver consistent, reliable results.
Learn More >Healthcare Captives
While captive insurance arrangements offer employers greater control and potential cost savings on employee benefits, including pharmacy costs, they struggle to maintain independence, access data-driven insights and ensure transparency when managing pharmacy benefits. Captives thrive on data-driven decision-making, but pharmacy data can be complex and difficult to obtain. RxLogic is highly perceptive of these issues and plays an important role in the successful implementation of pharmacy programs that require careful coordination and clear communication with members. Advanced technology solutions address risk and utilization management that help to control costs, improve health outcomes and ensure that captives gain full operational control. The transition is simple and supported, enabling captives to manage their benefits autonomously within weeks.
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IDNs/Hospitals
IDNs and hospitals face disconnected pharmacy workflows and limited visibility across inpatient and outpatient settings, which can result in inefficiency, missed savings and challenges in care coordination. RxLogic's SaaS-based adjudication platform integrates with clinical, financial and operational systems, providing real-time transparency, configurable benefit logic and workflow efficiency. Switching is seamless, allowing health systems to unify pharmacy operations without disrupting care delivery.
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Workers' Compensation
Facing constant challenges to manage state-specific regulations, injury-based formularies and complex fee schedules, workers' compensation pharmacy programs turn to RxLogic for simplification. RxLogic's advanced technology solutions adapt to each jurisdiction, automate workflows and streamline real-time data exchange across stakeholders. These capabilities are valuable to combating fraud, waste and abuse by opportunists or out-of-network providers. With a configurable rules engine, RxLogic helps administrators and PBMs reduce friction, accelerate approvals and ensure injured workers receive medications quickly and accurately.
Learn More >Manufacturer Copay Programs
Copay assistance programs are essential for improving access and adherence, but most legacy systems lack the flexibility and transparency manufacturers need. RxLogic provides top-tier copay support services through a modern infrastructure that integrates copay support directly into claims adjudication, enabling real-time eligibility, accumulator logic and benefit design. With full claim-level visibility and automated compliance, manufacturers and administrators can optimize programs, enhance forecasting and improve the patient and pharmacy experience — all through a seamless, connected platform.
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eVoucher
As healthcare affordability takes center stage, managing electronic discounts across networks requires precision and speed. RxLogic's eVoucher platform integrates directly into claims workflows, enabling seamless discount application and real-time adjudication across retail, mail and specialty settings. With flexible pricing logic and built-in compliance, manufacturers, payers and networks can launch targeted savings programs quickly — without custom code, third-party gateways or operational friction.
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