Corporate Pharmacy Services believes no two clients are the same, and tailors each program specifically to meet the needs of individual clients. Through our dedicated customer service center we work with our clients to establish a best-in-class program designed to trim excess cost from their pharmacy benefit management program while providing the upmost in customer care to the patients they serve. Corporate Pharmacy Services uses proactive management of every claim beginning with the initial prescription, including real-time review prior to dispensing, and in-depth utilization management to ensure correct billing of compensable medications.
PriorityRx Point of Injury Program
When an injured worker needs medications quickly, the PriorityRx program provides immediate access to the CPS nationwide network of retail pharmacies allowing for prompt processing of their prescription without approval delays. Benefits include:
- Capture the initial prescription at network discounts
- Claimant enrollment on-site as well as on-line
- Scalable program offering client workflow customizations and medication plans
- All invoicing from one source
Retail Pharmacy Network
CPS has established direct pharmacy contracts allowing for real-time electronic review of prescriptions. The CPS retail pharmacy network provides:
- 64,000 + retail locations
- Most National Chains and 20,000 Independent Locations
- Client Specific Customized Networks
- Real-time interaction to provide instant point-of-sale review of all medications prior dispensing
- Customizable Medication Plans at Payer and Claimant Levels
- Pharmacotherapy Case Management on All Claims
- Third Party Bill Solutions Providing the Greatest Savings for Clients
Mail Order Services
CPS has a fully operational mail order facility located in Gadsden, AL. Through our mail order, CPS is able to leverage our purchasing power with drug manufacturers in order to drive additional costs out of the system for payers. The mail order program is able to provide:
- Cost Plus Pricing
- 90 Day Supply of Medications
- Prescriptions Shipped with 2nd Day Delivery
- All Medications Screened for Compensability, Early Refill Request, Quantity Limits, etc.
- Toll Free Order Line for Claimants with Interactive Voice Response System
Compounding Pharmacy Services
CPS is able to offer our clients the ability to order compounded medications when ordered by a physician. Compounding offers a medication therapy alternative that is effective in some specific cases and can be delivered through methods such as gels and ointments applied directly to the site of injury. When compounded medications are ordered, the payer can refer these to CPS who works with the treating provider to obtain the compounded ingredients and supply these medications to the claimant at a significant cost savings to the payer.
No two injuries are ever the same and for this reason the approved drugs for each claim must be customizable as well. Clients have the ability to establish a preferred drug list which can be tailored at the claimant level depending on the nature of injury and underlying factors. By developing a claimant specific medication plan the payer is able to achieve maximum control and ensure the claimant receives only the medications they need during their rehabilitation.
Point of Sale Reviews
The cost of medications is a key driver in workers compensation, but an even greater expense is paying for medications that are not related to the injury. CPS has established a real-time adjudication process which allows us to review every medication prior to it being dispensed. These protocols can be customized by payer in order to provide maximum control of your pharmacy benefit program.
The goal of CPS utilization management programs is to reduce unnecessary medical cost without compromising the quality of healthcare claimants receive. Programs can be customized to meet the client's needs and include:
- Generic Conversion / Therapeutic Alternatives Program
- Narcotic (Pain) Management Program
- Pharmacotherapy Case Management Program
- Quantity Limits
- Prior Authorization Program
- Non-Injury Related Drug Use Program
- Off-label Drug Use Program
- Physician Profiling and Education Program
From a claim payer perspective it can be a daunting task to understand the complexities of the medical treatment for a specific claim. To assist with this, CPS has developed a process to assist the payer in addressing medical necessity as well as when a physician is prescribing a specific brand medication. In these instances CPS can reach out to the payer through multiple means to assess whether medication is related to the occupational injury along with suggesting therapeutic equivalent alternatives. These interventions can have a significant effect in lowering the cost of prescribed medications while ensuring the claimant is receiving the best possible medical care.
When it comes to pricing, no one will be more transparent than CPS. Our clients are able to easily interpret our invoices to see exactly what they are paying for each covered medication. In addition, CPS is the only mail order facility in the workers’ compensation market to offer a true cost plus pricing model thereby creating the greatest transparency of all.
Physician Dispensing and Third Party bills
Frustration. That's the consistent word we hear when we discuss third party billings with our clients and potential clients. Unlike our competitors, CPS does not simply reprice these bills to applicable state fee schedules. Instead, we have dedicated staff who work diligently at reducing and eliminating these billings. Through our proprietary process CPS is able to save our clients as much as 75% on Third Party Bills.
CPS offers programs for 3 types of business lines:
- Workers’ Comp – CPS will take care of your injured worker beginning at the point of injury until the injured worker no longer needs medication through the use of our Priority Rx Program, Retail Program and Mail Order Services.
- Auto Injury – CPS can coordinate benefits if the injured party has health insurance that should be first payor.
- MSA Custodial Administration – Most PBM’s treat MSA accounts and workers’ comp the same. At CPS we understand there is a difference. We combine our competitive pricing along with the knowledge we have acquired during our 20 years in the pharmaceutical industry to help patients get the most out of their MSA funding.
Savings Beyond Drug Discounts
Through our reporting capabilities CPS offers additional ways to save money. We do this by analyzing:
- Physician prescribing habits
- Top users
- Top drugs
In our continued efforts to lower your cost, we may suggest a pharmacotherapy review. This is an in depth look at the patient's drug history along with medical notes. This type of review allows us to eliminate unwarranted drug therapy, search for therapeutic and lower cost alternatives and detect over utilization of medication.