FAQ
We understand that your primary goal is to deliver value, reduce costs, and enhance the overall experience for your clients and their members. Whether you’re looking to streamline pharmacy operations, integrate advanced technology solutions, or explore cost-saving opportunities, this FAQ section is designed to address your most pressing concerns. If you have any additional questions, feel free to contact us for more personalized support.
1. What cost containment strategies do you offer to plan administrators?
We provide a range of cost containment solutions ranging from alternative sourcing, 340B drug discount program, manufacturer copayment assistance, preferred pricing through group purchasing organizations. Our aim is to provide your company with a comprehensive and holistic approach to cost containment with a guarantee that our turnkey resources and programs will enhance your overall net savings with no added expenses.
2. Can you provide an example of how you reduce the cost of prescription drugs for employer-sponsored health plans or other insured groups?
Here’s an example that illustrates how your company reduces the cost of prescription drugs for employer-sponsored health plans or other insured groups using a 340B program, combined with copayment assistance and a cost-plus pricing model.
3. Do you offer alternative sourcing options, such as international drug procurement?
Yes, we offer alternative sourcing options through international drug procurement to provide cost-effective solutions for employer-sponsored health plans, insured groups, and self-funded employer groups on behalf of brokers, benefit managers and TPAs.
We own and operate a central fill and specialty mail-order pharmacy that processes prescriptions efficiently and ensures timely delivery to members. Our mail-order infrastructure is compliant with all U.S. regulations and operates with full SOC-2, HIPAA, and PBM integration capabilities including claims adjudication, ensuring security and streamlined processing for employer groups.
We have leveraged our network of licensed and accredited pharmacies and wholesalers outside of North America. This allows us to source prescription drugs at lower costs from international markets where pricing controls are often more favorable than in the U.S. Countries involved in our network include those with strict regulatory compliance and pricing advantages for brand and specialty drugs.
We can provide upon request a vendor report, which includes:
Our cost containment programs which include several strategies mainly consist of international drug procurement, 340B drug discount program, and copayment assistance program which are designed to significantly reduce the cost of brand-name and specialty high cost drugs for employer-sponsored health plans, self-funded employers, and insured groups. Below is an illustrative overview of how each program works and the potential savings you can expect.
The 340B Drug Pricing Program is a U.S. federal program that was created under the Veterans Health Care Act of 1992 and signed into law on November 4, 1992. It is codified in section 340B of the Public Health Service Act. The program was established to help covered entities access lower-cost drugs and stretch federal resources as far as possible to serve more patients in need. The 340B discounts typically range between 25% to 50% of the Average Wholesale Price (AWP), though savings on certain medications can be even higher. Drug manufacturers must enter into an agreement with the Secretary of HHS to provide discounted drugs to eligible covered entities under the 340B program. They must offer the drugs at the 340B ceiling price, which is determined based on Medicaid rebate calculations. HRSA, under the U.S. Department of Health and Human Services (HHS), oversees the 340B program and ensures that covered entities and drug manufacturers comply with the rules and regulations of the program. Covered entities are required to maintain strict program integrity and compliance. They must ensure that the drugs purchased under the 340B program are used for eligible patients only and that they don’t engage in duplicate discounts (i.e., receiving 340B discounts and Medicaid rebates).
6. How does your 340B program benefit commercially insured groups?
Our 340B program extends cost-saving opportunities to employer-sponsored health plans and commercially insured groups by leveraging the discounts available to covered entities. This enables significant reductions in drug spending, especially on high-cost medications.
7. What are the eligibility requirements for the 340B program?
The 340B program has specific patient eligibility requirements that ensure the program's resources are appropriately directed. Below are the main criteria that define an eligible patient under the 340B program:
Savings are passed through in the form of reduced drug prices for plan administrators, creating a more cost-efficient pharmacy benefit. We provide transparent reporting to show the exact savings on a per-claim basis.
9. What types of medications are covered under the 340B program?
The 340B program includes most outpatient prescription drugs, including brand and specialty medications. However, we do not include controlled drugs as part of our 340B program.
10. How do you ensure compliance with 340B regulations?
Our 340B program is fully compliant with federal and state regulations. We use an external third-party auditor (TPA) to perform regular audits to ensure adherence by auditing various aspects of the program including: patient eligibility, inventory management, pricing compliance, and overall adherence to regulations.
11. Can the 340B program integrate with existing PBM or TPA systems?
Yes, we offer seamless technology integration through APIs that allow real-time data access and claims adjudication, ensuring that 340B claims are processed accurately and efficiently within your existing infrastructure.
12. How does owning your infrastructure and program help guarantee savings?
By directly owning and managing the entire supply chain and pharmacy operations, we eliminate the need for intermediaries which allows us to pass on the full savings directly to you resulting in lower prescription costs without hidden fees or markups.
13. What makes your model different?
Our program stands out due to its comprehensive infrastructure, cost containment solutions, and data-driven analytics that empower PBMs, TPAs, and other healthcare stakeholders to optimize their formulary and expand their offerings in the benefits marketplace. Here's what makes us different:
14. How can you guarantee savings on high-cost or specialty medications?
Since we own the sourcing and numerous distribution channels, we have direct access to discounted medications through programs like 340B, international procurement, and manufacturer partnerships. These strategies allow us to consistently offer lower prices, even for high-cost specialty medications.
15. Do you offer customizable savings solutions?
Yes, we tailor our cost containment strategies to meet the specific needs of your plan. Whether through international sourcing, the 340B program, or manufacturer rebate aggregation, we can customize the solution that delivers the maximum savings for your group.
16. How do you integrate technology to ensure maximum efficiency and cost savings?
Our proprietary technology platforms allow for real-time claims adjudication, API integration with existing systems, and data analytics to monitor drug utilization and pricing. By optimizing operational efficiency, we help reduce administrative costs and maximize savings across your plan.
17. How much can we expect to save using your program compared to traditional PBMs?
On average, our PBM clients see savings of 10% to 25% when compared to traditional PBM pricing models which can vary significantly depending on the mix of drugs and cost containment strategies employed. Also, we can conduct a detailed analysis to project your potential savings based on your current spend.
18. Do you provide ongoing adjudication and cost utilization reports?
Yes, we provide ongoing adjudication and cost utilization reports to ensure you have full visibility into the savings being achieved and the overall performance of your program. Our platform offers continuous monitoring and delivers transparent, real-time insights on key metrics, including:
Because we control the infrastructure and program, we have full oversight of compliance with HIPAA, SOC-2, and 340B regulations, ensuring that all savings are achieved within a fully compliant and legally sound framework. Our compliance team performs regular audits to ensure all guidelines are met.
20. What technology platforms does your pharmacy use for integration with PBMs or TPAs?
We leverage advanced technology platforms to ensure seamless integration with PBMs (Pharmacy Benefit Managers) and TPAs (Third-Party Administrators), providing a robust and efficient experience for all stakeholders involved. Our technological solutions include:
By leveraging integrated technology, real-time data exchange, and automated adjudication processes, our pharmacy and network pharmacies can efficiently provide real-time claims processing and adjudication for a PBM for International and domestic pharmacy claims. This streamlined approach improves operational efficiency, reduces claim turnaround times, and enhances the overall patient experience while ensuring compliance with regulatory requirements and PBM guidelines.
22. What type of reporting and analytics do you provide to TPAs or PBMs?
Our company employs a sophisticated reporting system that leverages advanced technology and data analytics to provide comprehensive, real-time insights into prescription utilization, cost trends, patient adherence, and overall savings. We can achieve this through a combination of integrated data systems, real-time collection, dynamic reporting tools, prescription utilization tracking, cost trend analysis, savings calculations, automated reporting, regulatory compliance and security.
23. How does your pharmacy handle high-volume claims processing?
Handling high-volume claims processing requires a well-structured approach, advanced technology, and efficient workflows. We utilize a number of tools and processes to ensure scalability to meet your needs: automated claims adjudication and processing, API integration, standardized workflow and queue management to robust training systems so we can meet the requirements of our clients, ultimately enhancing patient care and satisfaction.
24. What kind of customer service or case management support do you provide?
We can provide any level of customer service and prescription case management support on behalf of benefit administrators:
Ensuring HIPAA (Health Insurance Portability and Accountability Act) compliance is crucial for pharmacies and benefit administrators as they handle sensitive patient information. We have effectively safeguarded patient information, ensuring HIPAA compliance by implementing the following: administrative, physical and technical safeguards, data encryption and minimization, incident response and reporting, and routine assessments and improvements.
26. How do you safeguard against the entry of counterfeit drugs entering the drug chain supply when ordering from International sources?
We have implemented robust safeguards when procuring drugs from international sources by ensuring drug pedigree and protecting against counterfeit drugs. We have implemented the following measures to ensure drug pedigree which is important from a patient safety standpoint but also for maintaining trust and compliance within the healthcare system.
1. What cost containment strategies do you offer to plan administrators?
We provide a range of cost containment solutions ranging from alternative sourcing, 340B drug discount program, manufacturer copayment assistance, preferred pricing through group purchasing organizations. Our aim is to provide your company with a comprehensive and holistic approach to cost containment with a guarantee that our turnkey resources and programs will enhance your overall net savings with no added expenses.
2. Can you provide an example of how you reduce the cost of prescription drugs for employer-sponsored health plans or other insured groups?
Here’s an example that illustrates how your company reduces the cost of prescription drugs for employer-sponsored health plans or other insured groups using a 340B program, combined with copayment assistance and a cost-plus pricing model.
Example: Ozempic Prescription Cost Reduction
- Traditional Cash Price:
Cash Pay Price for Ozempic: $1,000 per month (regardless of strength). - Cost Reduction Strategy:
1. 340B Acquisition Cost: Through the 340B drug discount program, your company acquires Ozempic at a significantly reduced price. - 340B Cost: $300 for a 1-month supply.
2. Copayment Assistance: You enroll the patient in a copayment assistance program to further reduce their out-of-pocket costs. - Copayment Assistance Saving: $150 monthly.
3. Administrative and Covered Entity Fees: The costs for managing the 340B program, including administrative expenses and reimbursement to the covered entity, total $150. - Admin + Covered Entity Cost: $150.
4. Cost-Plus Pricing: Using a cost-plus pricing model, you add a margin to the 340B acquisition cost to determine the final selling price. - Net Selling Price: $400 (cost-plus price).
Final Calculation:
- Total Cost for 1-Month Supply: $400 for the employer group or insured member (after applying the 340B acquisition cost and copayment assistance).
- Savings: Compared to the traditional cash pay price of $1,000, this results in 60% savings for the member or employer group.
Summary of Benefits:
- Employer Group Savings: A reduction from $1,000 to $400 per month for Ozempic results in significant cost savings.
- Member Savings: The combination of 340B and copayment assistance lowers the out-of-pocket cost to an affordable level.
- Cost Containment: The cost-plus pricing model ensures transparency and continued savings compared to traditional PBM or retail cash pricing.
By leveraging both 340B pricing and copayment assistance programs, your company can significantly lower the cost of prescription drugs, offering a more affordable solution to employer-sponsored health plans and insured groups.
3. Do you offer alternative sourcing options, such as international drug procurement?
Yes, we offer alternative sourcing options through international drug procurement to provide cost-effective solutions for employer-sponsored health plans, insured groups, and self-funded employer groups on behalf of brokers, benefit managers and TPAs.
We own and operate a central fill and specialty mail-order pharmacy that processes prescriptions efficiently and ensures timely delivery to members. Our mail-order infrastructure is compliant with all U.S. regulations and operates with full SOC-2, HIPAA, and PBM integration capabilities including claims adjudication, ensuring security and streamlined processing for employer groups.
We have leveraged our network of licensed and accredited pharmacies and wholesalers outside of North America. This allows us to source prescription drugs at lower costs from international markets where pricing controls are often more favorable than in the U.S. Countries involved in our network include those with strict regulatory compliance and pricing advantages for brand and specialty drugs.
We can provide upon request a vendor report, which includes:
- Product pedigree: A full traceability report on the drug’s origin and handling, ensuring compliance with drug safety protocols.
Licensing: Documentation of the licensing status of the international pharmacies and wholesalers. - Insurance and corporate registration: Proof of liability insurance and corporate standing of our international partners.
- Standard Operating Procedures (SOPs): We can share SOPs on drug procurement, handling, and distribution to ensure all operations meet regulatory standards.
Our cost containment programs which include several strategies mainly consist of international drug procurement, 340B drug discount program, and copayment assistance program which are designed to significantly reduce the cost of brand-name and specialty high cost drugs for employer-sponsored health plans, self-funded employers, and insured groups. Below is an illustrative overview of how each program works and the potential savings you can expect.
- International Drug Procurement: Through our own pharmacy and established network of licensed international pharmacies and wholesalers, we source high-cost brand-name and specialty medications from countries where drug prices are typically lower due to government pricing controls or market conditions. These drugs are vetted for safety and compliance with all regulatory standards.
Savings:
- 20% to 35% savings on drugs with no rebates relative to Average Wholesale Price (AWP).
- For drugs with rebate programs the savings can range from 40% to 90% of AWP depending on the drug and size of rebate. .
- Use Case: For high-cost drugs like Humira or Ozempic, international procurement can yield savings of 50-70%, making it a valuable alternative for cost-conscious plans.
- 340B Drug Discount Program: Our nationwide 340B program allows eligible covered entities (such as hospitals, Federally Qualified Health Center serving underserved populations) to purchase outpatient drugs at reduced prices. We work closely with 340B covered entities to access these reduced-cost medications and pass those savings on to you.
Savings:
- Typical savings range from 20% to 40% on brand-name and specialty drugs that do not qualify for rebate.
- For drugs that qualify for rebates, savings can reach 40% to 60% relative to AWP.
- Example: A drug like Ozempic acquired at a 340B price of $300 can be sold for $400 (including administrative and other fees), saving over 50% compared to the retail price of $1,000.
- Copayment Assistance Programs: Reduce out-of-pocket costs for patients by enrolling them in manufacturer-funded copayment assistance plans. This assistance can be applied to offset part of the drug cost, typically for brand-name or specialty medications.
Savings:
$100 to $500+ per month in copayment assistance, depending on the drug and the manufacturer’s program.
When combined with the 340B program or international procurement, the total savings can increase significantly, further reducing the cost for the employer group.
Example: A member using Dupixent might save $150 per month through copayment assistance, on top of other savings from drug discount programs.
The 340B Drug Pricing Program is a U.S. federal program that was created under the Veterans Health Care Act of 1992 and signed into law on November 4, 1992. It is codified in section 340B of the Public Health Service Act. The program was established to help covered entities access lower-cost drugs and stretch federal resources as far as possible to serve more patients in need. The 340B discounts typically range between 25% to 50% of the Average Wholesale Price (AWP), though savings on certain medications can be even higher. Drug manufacturers must enter into an agreement with the Secretary of HHS to provide discounted drugs to eligible covered entities under the 340B program. They must offer the drugs at the 340B ceiling price, which is determined based on Medicaid rebate calculations. HRSA, under the U.S. Department of Health and Human Services (HHS), oversees the 340B program and ensures that covered entities and drug manufacturers comply with the rules and regulations of the program. Covered entities are required to maintain strict program integrity and compliance. They must ensure that the drugs purchased under the 340B program are used for eligible patients only and that they don’t engage in duplicate discounts (i.e., receiving 340B discounts and Medicaid rebates).
6. How does your 340B program benefit commercially insured groups?
Our 340B program extends cost-saving opportunities to employer-sponsored health plans and commercially insured groups by leveraging the discounts available to covered entities. This enables significant reductions in drug spending, especially on high-cost medications.
7. What are the eligibility requirements for the 340B program?
The 340B program has specific patient eligibility requirements that ensure the program's resources are appropriately directed. Below are the main criteria that define an eligible patient under the 340B program:
- Patients must receive healthcare services from the covered entity that qualifies for participation in the 340B program. The covered entity must maintain responsibility for the care provided to the patient.
- Patients must receive healthcare services that are consistent with the scope of services provided by the covered entity.
- The services must be provided by a healthcare professional who is either: employed by the covered entity, or Under contractual or other arrangements (e.g., an affiliated provider) such that the responsibility for the patient's care remains with the covered entity.
- T he care provided must be directly related to the healthcare services for which the covered entity is eligible for 340B participation.
Savings are passed through in the form of reduced drug prices for plan administrators, creating a more cost-efficient pharmacy benefit. We provide transparent reporting to show the exact savings on a per-claim basis.
9. What types of medications are covered under the 340B program?
The 340B program includes most outpatient prescription drugs, including brand and specialty medications. However, we do not include controlled drugs as part of our 340B program.
10. How do you ensure compliance with 340B regulations?
Our 340B program is fully compliant with federal and state regulations. We use an external third-party auditor (TPA) to perform regular audits to ensure adherence by auditing various aspects of the program including: patient eligibility, inventory management, pricing compliance, and overall adherence to regulations.
11. Can the 340B program integrate with existing PBM or TPA systems?
Yes, we offer seamless technology integration through APIs that allow real-time data access and claims adjudication, ensuring that 340B claims are processed accurately and efficiently within your existing infrastructure.
12. How does owning your infrastructure and program help guarantee savings?
By directly owning and managing the entire supply chain and pharmacy operations, we eliminate the need for intermediaries which allows us to pass on the full savings directly to you resulting in lower prescription costs without hidden fees or markups.
13. What makes your model different?
Our program stands out due to its comprehensive infrastructure, cost containment solutions, and data-driven analytics that empower PBMs, TPAs, and other healthcare stakeholders to optimize their formulary and expand their offerings in the benefits marketplace. Here's what makes us different:
Key Differentiators:
- End-to-End Infrastructure and Network:
We provide a robust infrastructure including mail-order and specialty pharmacies, international procurement, and 340B program integration. Our licensed network of accredited pharmacies and wholesalers ensures access to a wide range of prescription drugs, especially high-cost brand and specialty medications.
We enable you to enhance your program's reach without the burden of building or managing the infrastructure yourself. - Cost Containment Solutions:
Our focus on cost containment strategies targets the most expensive drugs in the healthcare system, ensuring significant savings for your clients.
Whether through alternative sourcing (e.g., international procurement) or 340B integration, we provide average savings ranging from 20%–35% on non-rebatable drugs and 40%–90% on drugs with rebate opportunities. - No Upfront Costs:
Unlike many service providers, we offer all our services free of charge. We operate on a network-based model where our partnerships with key players in the supply chain create value for all involved. This means your clients benefit from our cost-saving solutions, and we benefit financially by aligning our success with yours. - Formulary Optimization and Analytics:
Through advanced analytics, we provide insights into formulary optimization, helping you design smarter drug lists that focus on efficacy and cost-efficiency.
We help you identify savings opportunities, ensure rebate maximization, and reduce overall healthcare spending while improving clinical outcomes for members. - Scalability:
Our infrastructure is designed for scalability, allowing you to expand your offerings quickly without needing significant internal resources or investments.
This scalability extends to both domestic and international markets, giving you the flexibility to broaden your client base and product offerings. - Value-Driven Partnerships:
Our philosophy is to invest in you. We are committed to creating long-term partnerships where your success translates into mutual financial benefits.
We provide a holistic package of solutions that allow you to focus on growth and member satisfaction while we take care of the backend operations and cost-saving measures. - Compliance and Security:
Our services are fully HIPAA and SOC-2 compliant, ensuring that all data, transactions, and patient information are handled securely.
We maintain a high level of regulatory compliance across all programs, including strict adherence to 340B regulations, international sourcing laws, and payer requirements.
Since we own the sourcing and numerous distribution channels, we have direct access to discounted medications through programs like 340B, international procurement, and manufacturer partnerships. These strategies allow us to consistently offer lower prices, even for high-cost specialty medications.
15. Do you offer customizable savings solutions?
Yes, we tailor our cost containment strategies to meet the specific needs of your plan. Whether through international sourcing, the 340B program, or manufacturer rebate aggregation, we can customize the solution that delivers the maximum savings for your group.
16. How do you integrate technology to ensure maximum efficiency and cost savings?
Our proprietary technology platforms allow for real-time claims adjudication, API integration with existing systems, and data analytics to monitor drug utilization and pricing. By optimizing operational efficiency, we help reduce administrative costs and maximize savings across your plan.
17. How much can we expect to save using your program compared to traditional PBMs?
On average, our PBM clients see savings of 10% to 25% when compared to traditional PBM pricing models which can vary significantly depending on the mix of drugs and cost containment strategies employed. Also, we can conduct a detailed analysis to project your potential savings based on your current spend.
18. Do you provide ongoing adjudication and cost utilization reports?
Yes, we provide ongoing adjudication and cost utilization reports to ensure you have full visibility into the savings being achieved and the overall performance of your program. Our platform offers continuous monitoring and delivers transparent, real-time insights on key metrics, including:
- Drug Utilization: Track which medications are being prescribed and dispensed, allowing you to manage formulary performance and identify high-cost drugs or potential savings opportunities.
- Cost Trends: Get a clear view of evolving cost patterns across different therapeutic categories and drug classes, helping you proactively manage spending and adjust strategies accordingly.
- Adjudicated Claims: Access detailed information on adjudicated claims, providing a clear breakdown of pricing, rebates, copayment assistance, and any other relevant financial data.
By offering customized reports at regular intervals, we ensure you have the information needed to optimize drug costs and improve outcomes for your clients. You can easily track progress, measure savings, and make informed decisions to further enhance your program's value.
Because we control the infrastructure and program, we have full oversight of compliance with HIPAA, SOC-2, and 340B regulations, ensuring that all savings are achieved within a fully compliant and legally sound framework. Our compliance team performs regular audits to ensure all guidelines are met.
20. What technology platforms does your pharmacy use for integration with PBMs or TPAs?
We leverage advanced technology platforms to ensure seamless integration with PBMs (Pharmacy Benefit Managers) and TPAs (Third-Party Administrators), providing a robust and efficient experience for all stakeholders involved. Our technological solutions include:
- Compatibility and Integration: By supporting various industry-standard protocols and data formats, we facilitate smooth integration and interoperability, enabling you to maintain existing workflows while enhancing your capabilities with our solutions. We also utilize API (Application Programming Interface) integration, which allows for direct communication between our systems and those of PBMs and TPAs. This facilitates efficient data exchange and ensures that all parties have access to the most current information regarding claims, eligibility, and drug utilization. With API integration, we can automate processes such as claim submissions, approvals, and reimbursement requests, reducing manual errors and speeding up the overall workflow.
- Real-Time Data Access: We provide real-time data access so that benefit administrators can retrieve up-to-date information on claims status, pricing, and member eligibility without delay. Our technology platform supports instant updates on drug utilization and cost trends, allowing for proactive decision-making and timely adjustments to formulary management or cost containment strategies.
- Claims Adjudication and Management Software: We employ domestic and international claims adjudication and management software designed to handle the complexities of pharmacy claims processing.
- User-Friendly Interface: We can provide you with a user-friendly interface that allows you to access necessary information, and generate reports. without extensive training or technical knowledge.
- Comprehensive Analytics Tools: We perform comprehensive analytics allowing you to review drug utilization cost trends and patterns while monitoring savings while identifying lost opportunities.
By leveraging integrated technology, real-time data exchange, and automated adjudication processes, our pharmacy and network pharmacies can efficiently provide real-time claims processing and adjudication for a PBM for International and domestic pharmacy claims. This streamlined approach improves operational efficiency, reduces claim turnaround times, and enhances the overall patient experience while ensuring compliance with regulatory requirements and PBM guidelines.
22. What type of reporting and analytics do you provide to TPAs or PBMs?
Our company employs a sophisticated reporting system that leverages advanced technology and data analytics to provide comprehensive, real-time insights into prescription utilization, cost trends, patient adherence, and overall savings. We can achieve this through a combination of integrated data systems, real-time collection, dynamic reporting tools, prescription utilization tracking, cost trend analysis, savings calculations, automated reporting, regulatory compliance and security.
23. How does your pharmacy handle high-volume claims processing?
Handling high-volume claims processing requires a well-structured approach, advanced technology, and efficient workflows. We utilize a number of tools and processes to ensure scalability to meet your needs: automated claims adjudication and processing, API integration, standardized workflow and queue management to robust training systems so we can meet the requirements of our clients, ultimately enhancing patient care and satisfaction.
24. What kind of customer service or case management support do you provide?
We can provide any level of customer service and prescription case management support on behalf of benefit administrators:
- Electronic Prescribing (e-Prescribing)
Facilitate the electronic transmission of new prescriptions from healthcare providers to the pharmacy, ensuring swift and accurate processing.
Enable pharmacies to send refill requests directly to providers, streamlining the prescription renewal process. - Order Placement and Management
Manage prescription orders through a centralized platform, allowing for efficient processing and tracking of medications.
Ensure timely order fulfillment and provide status updates to both patients and administrators regarding prescription availability and estimated delivery times. - Patient Engagement
Utilize automated messaging systems to send reminders for medication refills, adherence tips, and follow-up communications to enhance patient engagement.
Offer personalized communication channels (e.g., phone, text, email) for patients to reach out with questions or concerns about their medications. - Facilitating Patient Enrollment in Assistance Programs
Assist patients in enrolling in copayment assistance or other financial support programs to help reduce out-of-pocket costs for medications.
Provide guidance on eligibility requirements and documentation needed for enrollment in various assistance programs. - Tracking Orders and Prescription Status
Implement real-time tracking systems that allow patients and administrators to monitor the status of their prescriptions from order placement to delivery.
Notify patients and administrators of any delays or issues with order fulfillment, providing timely updates to manage expectations. - Handling Customer Service Inquiries
Establish dedicated customer service teams to address inquiries related to prescription status, medication information, and billing questions. - Reporting and Analytics
Provide administrators with detailed reports on prescription utilization, adherence rates, and program effectiveness to support data-driven decision-making.
Analyze trends in patient inquiries and feedback to continuously improve service quality and address common concerns. - Collaboration with Healthcare Providers|
Act as a liaison between patients and healthcare providers to resolve any issues related to prescriptions, ensuring clear communication and coordination of care.
Facilitate the sharing of relevant patient information to improve treatment outcomes and medication management. - Patient Education and Support
Offer educational resources to patients regarding their medications, potential side effects, and proper usage to enhance adherence and safety.
Provide access to pharmacists for consultation on medication therapy management and health-related questions. - Quality Assurance and Feedback Mechanisms
Implement quality assurance processes to monitor service delivery and identify areas for improvement.
Ensuring HIPAA (Health Insurance Portability and Accountability Act) compliance is crucial for pharmacies and benefit administrators as they handle sensitive patient information. We have effectively safeguarded patient information, ensuring HIPAA compliance by implementing the following: administrative, physical and technical safeguards, data encryption and minimization, incident response and reporting, and routine assessments and improvements.
26. How do you safeguard against the entry of counterfeit drugs entering the drug chain supply when ordering from International sources?
We have implemented robust safeguards when procuring drugs from international sources by ensuring drug pedigree and protecting against counterfeit drugs. We have implemented the following measures to ensure drug pedigree which is important from a patient safety standpoint but also for maintaining trust and compliance within the healthcare system.
- Vendor Due Diligence
Licensing Verification: Ensure that all international pharmacies and wholesalers are licensed and accredited by relevant regulatory bodies in their respective countries.
Background Checks: Conduct thorough background checks on suppliers, including their history, reputation, and compliance with local regulations. - Drug Pedigree Documentation
Chain of Custody Documentation: Require comprehensive documentation that tracks the entire supply chain of the drug, including every entity involved from the manufacturer to the point of sale.
Certificates of Analysis: Obtain certificates of analysis from manufacturers or suppliers, confirming the authenticity and quality of the drugs being imported. - Use of Technology
Serialization: Implement serialization practices that assign a unique identifier to each drug package, enabling tracking through the supply chain.
Blockchain Technology: Explore blockchain solutions to create a transparent and tamper-proof record of the drug’s journey, from manufacturer to distributor to pharmacy. - Compliance with Import Regulations
Customs Documentation: Maintain accurate and complete customs documentation for all shipments to facilitate transparency and compliance with legal requirements.