BeneCard PBF's clinical organization creates customized clinical management programs based specifically on your demographics and claim history. The basis of our recommendations is always solid data analytics coupled with decades of experience in creating and delivering effective clinical programs. The goal of our clinical programs is to achieve the lowest net cost consistent with the highest standards of evidence-based medical practice.
Our in-depth analysis identifies:
- Patient, prescriber, and pharmacy patterns
- Member safety issues
- Cost saving opportunities
- Personalized impact of drug pipeline
After analyzing your plan information, we formulate a personalized program for you that will:
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Control claims cost
- Prior authorization
- Medication quantity control program
- Specialty pharmacy
- Starter dose
- OTC coverage
- 90 day at retail
- Dose Optimization
- Compliance and polypharmacy programs
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Impact patient health and safety
- Concurrent drug utilization review (DUR)
- Retrospective drug utilization review (DUR)
- Clinical edits including ICD-9
- Recall notifications
- E-Prescribing
- Fraud and abuse control
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Keep your members healthy
- Disease-specific health management - RxTrainer level 1, 2, 3
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Increase generic utilization
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Member-specific interventions
- Clinical cost management programs
- Therapeutic substitution
- EOB
- Custom generic messaging at point of sale
- Step therapy
- Personalized medicine test kits
- Zero dollar co-pay for generics
- Physician practice pattern analysis / communications
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Generic alternatives and pricing comparison online
- E-Prescribing
- Therapeutic MAC
BeneCard PBF - evidence-based clinical management personalized to your unique needs.
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