Services
- Electronic Claims Processing (including member submitted paper claims)
- Retail Network Management Services, including national and custom local networks
- Prior Authorization services
- Appeals (initial determinations and 1st level)
- Communication for formulary/benefit changes to members and physicians
- Rebate Administration
- Reporting and Information Analysis Solutions
- Maximum Allowable Cost (MAC) Management
- Medicare EGWP and RDS Solutions
- Fully Integrated Call Center and Help Desk
- Member Communications and ID Cards
- Member Web Portal
- Client Web Portal
- Drug Utilization Review
- Clinical Services and Consulting
- Formulary Management
- Enrollment and Eligibility Management
- Benefit Plan Design and Management
- Diabetes Management
- International Pharmacy Options
