President Robert Shelley and Vice President Tom Holden will co-chair PBM Panel on CMS-mandated rejection monitoring and reporting
SCOTTSDALE, Ariz., Feb. 10, 2014 /PRNewswire/ — PSRx Advisors President Robert Shelley and Vice President Tom Holden will co-chair the "PBM Panel" session on Tuesday, February 11 at the Health Care Compliance Association's Managed Care Compliance Conference.
CMS has mandated that plans review rejected claims daily to ensure the member is not disadvantaged, in particular those under transition status and those being treated by one of the "six protected classes" of pharmaceuticals.
"Daily rejection data reporting from PBM is unfiltered and voluminous. Plans usually have limited resources to review rejections and respond in a timely manner. The review is manual and requires more resources than available for expected oversight," notes Shelley.
Holden adds: "Automation, pharmacy outreach, process management…every program is manageable if you have the right tools. That's where we think PSRx Advisors comes in."
PSRx Advisors representatives can be found at Booth 5. For more information about the conference, go to www.hcca-info.org/managedcare.
About PSRx Advisors
PSRx Advisors is a leading next-generation pharmacy consulting firm, focused exclusively on Pharmacy Benefit Management (PBM) consulting. Utilizing proprietary data analytics tools, we provide PBM assessment, Request for Proposal (RFP) consulting and more. Our goal is simple: to ensure that our clients maintain industry-leading pharmacy benefit risk programs. Our approach is straightforward: we deliver clear, actionable information to our clients on their prescription drug programs, providing them with the tools they need to manage their pharmacy benefit programs using data rather than intuition or guesswork.
For more information, please contact Robert Shelley, Email.