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InformedRx Employer Solutions:

Electronic Claims Adjudication
Pharmacy Network Management
Mail Services/Specialty Pharmacy
Call Center
Drug Utilization Review
Clinical Services and Consulting
Formulary
Rebate Administration
MAC Management
Enrollment and Eligibility
Benefit Plan Design and Management
Reporting and Information Analysis Solutions
Member Information Portals

Commercial Payer Solution Employer Solution Outcomes

InformedRx comprehensively addresses escalating issues in fiscal management—soaring healthcare costs and eroding margins—while delivering the highest quality of care for plan participants. We address the increased interest of self-funded employers and third-party administrators to gain a greater level of decision-making authority and control over pharmacy benefit dollars. Experience the value of control.

Savings

Receive 100 percent of all manufacturer rebates and point-of-sale discounts
Maximize savings with full price transparency and à la carte, fee-for-service pricing
Eliminate excessive PBM revenue streams tied to drug spend
Achieve a greater level of cost and clinical control over drug product selection

Quality

Ease administrative burden and increase operational efficiency through simplified processes
Enhance the quality of care for employees and their dependents through targeted clinical programs
Attract and retain employees through innovative benefit programs that promote healthcare involvement and provide convenient access to Web-based tools

Flexibility

Maximize cost control and quality of care through a full range of customizable clinical management, specialty, retail network and mail order programs
Experience simplified administration and informed decision support—with on-demand data access and custom-designed reports

Gain control of pharmacy benefit dollars—with complete financial transparency—and maximize cost control and quality of care through a full range of pharmacy benefit management services.

Electronic Claims Adjudication: In 1991, we became one of the first companies to bring to the market a claims processing system designed for online, real-time adjudication of prescription drug claims at the point of sale. Today, more than one billion prescriptions are managed using this state-of-the-art claims processing system.

Pharmacy Network Management: InformedRx offers organizations access to our national retail network of more than 50,500 pharmacies. In addition, we do not retain undisclosed “spread” revenue on dispensing fees and AWP percentages.

Mail Services/Specialty Pharmacy: InformedRx maintains preferred relationships with specialty/mail program providers. Our approach and philosophy is consistent with retail, mail service and specialty providers. We do not maintain a financial interest or receive revenue streams from these areas.

Call Center: Single-point-of-convenience. InformedRx has one primary call center for both plan participant and pharmacy calls. Our representatives are available to answer questions regarding prescription orders, plan design, and pharmacy locations. Members will find comfort in knowing they can receive solid, reliable information from an InformedRx pharmacist through a convenient toll-free number.

Drug Utilization Review: InformedRx’s pre-dispensing DUR edit checks are performed on an online, real-time basis for mail and retail pharmacies. All prescriptions are checked for participant eligibility and plan design features and are then compared against previous histories of prescriptions filled by the same pharmacy, by other participating retail network pharmacies and by the mail service pharmacy.

Clinical Services and Consulting: InformedRx’s clinical programs utilize complete prescription drug information to reduce the growth rate of prescription drug costs and to increase the quality of care and patient safety. InformedRx’s unique approach to managing the prescription drug benefit goes beyond price and product and focuses on utilization.

Formulary: The goal of InformedRx’s Formulary is to provide the highest quality pharmaceutical care at the lowest cost. As an independent (non-manufacturer owned) provider, we have no hidden agendas relative to promoting products to our clients. We can administer (adjudicate) formularies based on specific plan design needs.

Rebate Administration: All revenues received by InformedRx from pharmaceutical manufacturers, related to our clients’ pharmacy programs, are disclosed. No games. InformedRx will not profit at the expense of its clients.

MAC Management: InformedRx’s MAC list and pricing are designed to provide adequate reimbursement to promote generic dispensing by the pharmacy, while achieving competitive discounts and cost controls on generically available drug products.

Enrollment and Eligibility: Our system offers full-service eligibility management capabilities. We also offer our clients the ability to easily perform eligibility updates online, in real time.

Benefit Plan Design and Management: InformedRx can accommodate any plan design option required and can support a virtually unlimited number of benefit design variations. We also provide benefit design recommendations based on the client’s specific needs. Benefit designs can be changed online, in real time, by InformedRx or client benefits staff.

Reporting and Information Analysis Solutions: Two main levels of reporting are available from InformedRx: our standard reporting package (which includes a large menu of unique reports designed specifically for employer and third-party administrator clients), and our online analytical decision support tool that is designed to meet and exceed our clients’ expectations.

Member Information Portals: The InformedRx member Web site invites members to learn more about their prescription benefit programs, their medication histories, drug information, and related industry news. The site can be customized with a client's logo and name, links to the organization’s Internet home site, and up-to-date news bulletins about your organization.

Experience the Value of Control with InformedRx.