Managing Medical Specialty is Not Complicated
Medical Specialty is Not the Management Problem That Is Advertised! Employers and Health Plans can review performance to make Specialty Rx more efficient, accurate and less costly.
Pro Pharma announces innovative methods for Managing Medical Specialty Claims Payment and Analyses to correct claim adjudication issues. Dr. Stern, President of Pro Pharma Pharmaceutical Consultants, Inc. (Pro Pharma) states, "Individual and ongoing batch analysis is standard operating procedure; so that all claims can be validated against a comprehensive set of tests and criteria, as well as Utilization tests to validate clinical performance and effectiveness."
Carol Stern, CEO of Pro Pharma explains that "Specialty Pharmacy are not the only medications that can be managed comprehensively. Medical Specialty has the benefit of diagnosis, total resource utilization and cost of care, competitive pricing options, duplicative therapy, and more! This opens up the management of Specialty Pharmacy as well as Medical Specialty which allows Payers to manage specialty pharmacy both for drugs covered under the medical as well as the pharmacy benefits." She goes on to define that there are "no middle men in this totally TRANSPARENT process and fees are based on analyses."
Pro Pharma invites readers to review the list below to see how easy it is to ensure that you can receive comprehensive oversight of Specialty medications under medical and pharmacy benefits without the uncertainty of hidden fees! EVERY SAVINGS IS PASSED ON TO YOU!
Medical Specialty Analyses have all of the benefits of transaction management and utilization review oversight. Claims transactions are easily validated individually or in batch. Transactions are tested against all elements of the claim including validation of:
- Medication approved for the submitted DIAGNOSIS
- DOSAGE and QUANTITY validation checks
- Maximum QUANTITY check
- UTILIZATION check
- WASTAGE calculation and validation
- Comparative Unit Cost Analysis
- Medical rebates
- And many more
Utilization Review is comprehensive and covers all elements of clinical therapeutics including validation of:
- Companion GENETIC test check
- Antibiotic Stewardship
- FDA Alert check
- Drug Interactions
- Adverse Drug Reactions
- Drug-Induced Disease
- Formulary management
- Fraud, Waste, Abuse (FWA)
Let us know your thoughts and if you are interested in seeing some of these functionalities at work on a GoToMeeting conference call so that you can visualize how it might be of use to you and your organization at (888)701-5438, extension 725 or firstname.lastname@example.org and feel free to visit our Website at www.propharmaconsultants.com
About PRO PHARMA
Pro Pharma is a multi-service, woman owned, privately held consulting firm offering a vast portfolio of services to public and private entities including self-insured employers, unions, public employers, for-profit hospitals and integrated health networks, health care insurance companies, worker's compensation insurers, small-to-medium sized HMO's, and physician groups.
As a primary service to plan sponsors for achieving below trend results, Pro Pharma provides an integrated program of administrative process improvements, clinical quality oversight, and provider/member education.
Pro Pharma's Consulting services are grounded in the use of data and the communication of that information to define benefit trends, drivers and other analytical indicators. Pro Pharma markets Biotech Modeling™, Invoice Screening™, Quality Management Program™, and Treatment Calendar™. The Company directly markets its products in the U.S. and collaborates with partners to reach international markets.
For more information about PRO PHARMA, please visit http://www.propharmaconsultants.com