SERVICES

Advocacy, expertise, and service for better pharmacy solutions.

The all-encompassing solution for pharmacy benefit management.

We'll manage every aspect of your client's pharmacy plans. Benefits include volume-purchasing discounts, a boutique service model with access to RxAssure, our in-house assistance center for members.

 

Insightful consulting at your service.

Let us consult on your pharmacy accounts. From PBM procurement to ongoing guidance, you’ll gain insights and strategies from industry-leading experts to keep you ahead of the benefit curve.

 

An independent assessment of your existing plan's performance.

Let us conduct a line-by-line contract review to determine (1) your plan’s performance, (2) PBM compliance with contract terms, and (3) how competitive the contract is compared to the market.

 

Exclusive access to innovative health and wellness programs.

Workplace wellness programs reduce an employer's healthcare costs. We've vetted the market to align with vendors who provide a guaranteed ROI and benefits that support healthier employees.

 

 

Gain the clarity and insight of
industry experts.

Focused Consulting Services

Even the most experienced pilot needs a co-pilot. Let RxBenefits guide you through the intricacies of PBM procurement and contract management. With our full-service assistance, your clients can save an average of 14% without a reduction in employee benefits. Plus, once the contract is in place, we actively monitor it to verify all performance guarantees.

PBM Procurement


For clients that need to contract directly with a PBM, we offer a full service approach that includes:

 

Defining scope and key decision criteria for the RFP process

Tailoring qualitative and quantitative questionnaires

Delivering a comprehensive proprietary RFP to leading PBMs

Evaluating all financial pricing models including transparent and traditional offers, as well as other more progressive options in the market, from Average Script Price (ASP) and formulary options to preferred networks

Analyzing RFP responses to identify finalists

 

Managing on-site presentation

Evaluating all PBMs qualitatively for overall comprehensive approach, capabilities and programs, including clinical, drug utilization, implementation service model, specialty, technology and member engagement

Producing a comprehensive report recommending the best PBM for each client’s unique needs

 

Ongoing PBM Oversight
and Management


We provide service for the life of the client contract with the PBM that includes:

 

Managing the contracting process

Oversee implementation meetings

Ensuring performance guarantees are met

Managing eligibility & claims exchange with third party vendors

Conducting clinical reviews

Providing plan design & co-pay modeling

Analyzing and assessing performance quarterly, based on guaranteed performance

Managing the PBM true-up of actual performance to contract guarantees

 

Comparing results to peers

Offering data support of claims, data warehousing and eligibility

Supplying a team of experts for pharmacy analytics and reporting

Hosting web-based client seminars

Comparing results to peers

Providing ongoing management to ensure PBM honors all commitments

Access to PBM senior leadership