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Ö Companies
with an Indemnity Benefit Program
– The online TeleCLAIM system automatically improves much of
inflated drug costs simply by providing an eligibility confirmation at
the Pharmacy counter. The online system easily eliminates the
probability of excessive fraud, abuse and over-utilization.
It will prevent simultaneous multiple
Pharmacy dispensing with the same Rx. When we add the other filtering
techniques of influencing low cost Generics, refill-too-soon intercept
for Maintenance therapies, and many other screening, a significant
cost containment will result.
Indemnity programs also have an
expensive administrative cost with screening submitted vouchers of
purchases. This is automatically eliminated.
Prior experience indicates that the
company can provide a guarantee of savings approaching 33% by reducing
utilization and shrinking ingredient cost by a greater use of lowest
cost Generics.
Ö
Companies with NO Drug Benefit Program – Competition
alone makes adding a Drug Benefit program a necessity. Reluctance in
the past to offer this benefit was the high risk of uncontrollable
over-utilization. Online PBM systems make this one remaining benefit a
minimum-risk reality by a managed program with deductibles and maximum
allowance.
In these circumstances the company
believes that it can commit to a defined cost per individual covered.
The demographics of the Group covered will dictate the quotation made
by the company. Simply stated, absent any unexpected Acts-of-God, a
young population is a substantially lower cost liability than one with
an older population.
The lease basis will use a PMPM (Cost
per Person per Month) parameter to adjust downwards (guarantee) any
lease fees to reflect overages of the PMPM baseline quotation.
Ö Companies
with an Existing Online Drug Benefit Program – The
lessor will guarantee a lower PMPM (Cost Per Person Per Month) that
will result in substantial savings. This commitment is made on the
knowledge that the TeleCLAIM system includes techniques accumulated
over 15 years of experience with complex benefit programs in North and
South America.
The reader is encouraged to review
the details of the PlanBuilder module that can be found in the company
website www.dprx.com under Software
Products section.
Other collateral operational costs
will be lower and offer significant savings. The TeleRx and TeleVISTA
system modules operating in the Internet provide efficiencies that
surpass the other known alternative systems.
The TeleCLAIM++ system also offers
interactive communication with Intuit’s QuickBooks Accounting
package. This is a major component to complete the overall need of a
PBM business. Total financial reporting is provided for Tax returns
and extensive Accounts Payable and Accounts Receivable components for
the PBM.
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