The Benefit of Options
We offer a robust marketplace of best-in-class, traditional, and transparent pharmacy benefits options and cost-containment programs. This enables clients to choose the solutions that strike the right balance between member access and savings to achieve their unique goals. Our process fosters competition among The Big Three PBMs and vendors to secure the most cost-effective options.
A Comprehensive Approach, from Clinical Management, to Cost Containment, to Customer Satisfaction
Every client deserves a pharmacy benefits solution aligned with their goals, and client and member services aligned with their needs. RxBenefits operates free from formulary placement incentives, rebates, spread pricing, dispensing fees, or other potential conflicts. We are paid flat PMPM administrative fees. Our incentive is to help our clients realize strategic savings and sustainable success.
Managing $3B spend and 3M member lives, RxBenefits has the scale, the skills, and the expertise to handle every aspect of the pharmacy benefits process, from contracting, to independent clinical management, to cost containment, to ongoing account service and exceptional client and member support.
Quarterly business reviews and annual plan performance reviews ensure clients get everything promised in their contract, with terms adjusted as necessary, and all negotiated savings passed on to the client.
It starts with a comprehensive financial analysis and a detailed plan tailored to each client’s unique goals and service needs.
A competitive marketplace of solutions gives clients control to select the PBMs and programs that work for them.
Comprehensive clinical management helps to contain costs and manage spend while ensuring members receive clinically effective medications at the lowest possible cost. Our clinical savings are guaranteed!
Comprehensive, Independent Clinical Management for Better Outcomes
To ensure a healthy, sustainable bottom line and the health and safety of employees, clients need a pharmacy benefits partner focused solely on doing what’s in the best interests of the plan and its members. A client-aligned approach to sound clinical management is essential in today’s evolving pharmacy landscape. Unlike PBMs that use an automated process to approve nearly 90% of their prior authorizations (PAs), RxBenefits’ independent team of licensed pharmacists review chart notes, lab results, medical records, and well-established clinical best practices and guidelines established by the Food and Drug Administration (FDA) to make unbiased PA decisions that result in better outcomes and lower costs. Clinical utilization management focuses on the plan’s members that have the most serious conditions and drive the highest plan spend.
Specialty Cost Containment Solutions Lower Costs and Improve Access
To ensure a healthy, sustainable bottom line and the health and safety of employees, clients need a pharmacy benefits partner focused solely on doing what’s in the best interests of the plan and its members. A client-aligned approach to sound clinical management is essential in today’s evolving pharmacy landscape. Unlike PBMs that use an automated process to approve nearly 90% of their prior authorizations (PAs), RxBenefits’ independent team of licensed pharmacists review chart notes, lab results, medical records, and well-established clinical best practices and guidelines established by the Food and Drug Administration (FDA) to make unbiased PA decisions that result in better outcomes and lower costs. Clinical utilization management focuses on the plan’s members that have the most serious conditions and drive the highest plan spend.
Tailored Solutions Aligned with the Needs and Resources of Hospitals and Health Systems
From strained financials to government regulation to employees who double as patients, healthcare clients have unique needs and requirements of their pharmacy benefits. RxBenefits leverages our expertise to partner with hospitals and health systems to create tailored solutions that meet these needs, including maximizing the client’s 340B program and making the most of in-house pharmacies. Decades of healthcare-specific experience allow us to design client-aligned plans that avoid common (and not-so-common) contractual pitfalls, aided by our hospital-focused account management and award-winning member service teams who deliver peace of mind for clients and their members.
Diabetes Support Program
Protecting Clients and Members from the Cost of Poorly Managed Diabetes
For most clients, medications for diabetes and metabolic syndrome (also known as pre-diabetes) are a top expenditure. For employees, the health impact of poorly managed diabetes can be devastating. In partnership with tria HEALTH®, RxBenefits offers pharmacist-led, human-to-human support, care coordination, and education to help members with these conditions become and remain healthy.
Account Management
Responsive, effective account management like you’ve never experienced.
Our Account Management teams function as extensions of our clients, finding quick, effective solutions to their biggest pharmacy benefits problems so they can focus on their business. Dedicated teams are based throughout the U.S. to be closer to the clients they serve, providing regular, ongoing reporting and proactive recommendations if adjustments are needed. We give our clients what we’d want for ourselves: care, compassion, and a focus on quick resolution.
48
NPS*
Offering world-class service and support.
We’re particularly proud of our client Net Promoter Score (NPS) of 48*. NPS is a measure of customer loyalty, and in an industry where most companies have a score below ten, we’re pleased our clients find our service to be world-class.
*Among clients highly familiar with RxBenefits
Client Services
When you need support now, you need it now.
Our Client Services and Account teams work together to ensure clients get the help they need exactly when they need it. Client Services is a centralized, accessible, responsive team technologically equipped to handle issues like eligibility questions or drug overrides. Employers and benefits advisors also have access to their plans via two distinct self-service portals: My RxBenefits Book for benefits advisors and My RxBenefits Plan for employers.
Member Services
Because members don’t reach out for help with things that don’t matter.
Whether they’re trying to get medication for a loved one or they just have a question and need a quick answer, members’ concerns deserve immediate attention. Every call to our 100% U.S.-based Member Services team is quickly directed to a live, compassionate representative who is equipped and empowered to help. Our team members are evaluated based on how well they help members who call with problems, not how quickly they can get those members off the phone – which is reflected in our four consecutive Stevie Awards for excellence in customer service.
Additionally, our member portal, gives members easy access to their benefits and communication with our team from the tip of their fingers.
Contact Member Services
Monday – Friday
7:00 am – 8:00 pm CST
800.334.8134
customercare@rxbenefits.com
