Services
| Implementation Management |
Account Management |
Claims Adjudication |
Customer Service |
Network Management |
Formulary Management |
Mail-Order Service |
Clinical Management |
| Management Reporting |
IdealScripts has extensive knowledge and experience in providing employers and health-plan administrators with the highest quality pharmacy benefit management available in the industry today. Our formula for success consists of custom-tailored benefit design, coupled with innovative cost-management strategies - all backed by our focus on responsive account management and quality customer service.
Implementation Management encompasses the development, implementation and analysis of clinical and cost-management functions. These include:
- Plan setup and tracking of outstanding tasks and timeline monitoring to ensure seamless transition from a vendor to IdealScripts
- Preparation for claims testing prior to “going live” to protect against potential setup errors and interruptions.
Account Management means “Account Relationship Responsibility.” This includes:
- Coordination of all IdealScripts internal functions for ongoing customer management
- Continuous monitoring and improving the pharmacy benefit through management tools, reporting, analysis and performance review
- Consultative strategic planning for benefit, direction and future program enhancements
- Benefit design analysis for optimal plan experience
- Semi-annual account management satisfaction survey
Our claims processing system (RxCMS) is a single database that ensures complete integration of retail, mail-order, and Internet claims data. The system technology incorporates online capabilities that are mirrored in the retail, mail-order, and Internet environments. Our multiple-edit functions protect and promote the quality of care with such tools as safety warnings against drug interactions, Generic promotions and plan-specific guidelines.
For answers to claims questions you may contact our Provider Service call center and speak with a Customer Care Professional (CCP). You can also reference our Pharmacy Manual.
top of page
IdealScripts is committed to improving the quality of care provided to plan participants. IdealScripts senior management team provides strategic direction, final approval and ongoing support to ensure its Customer Care Department is aligned with business objectives. Customer service has been central to the development of IdealScripts with a clear focus on achieving specific goals for our customer service teams.
top of page
IdealScripts has approximately 53,000 participating pharmacies nationwide to provide convenient access for all members. Many clients prefer custom networks tailored to their specific needs. Depending upon client needs, IdealScripts can develop a network to meet the specific client preferences.
top of page
Formulary Management programs play an important role in managing pharmacy benefit costs without compromising the well-being of members or the medical guidance of their physicians. Coupled with plan design, formulary management helps promote cost-conscious prescribing and provides members with information about coverage and access to prescription drugs.
We offer formulary options designed to deliver the overall lowest net drug cost while encouraging therapeutically sound prescribing and dispensing practices. Other formulary options include:
- Open formulary
- Tiered co-payments
- Closure of specific or all therapeutic classes on the Performance Drug List
- Closed formulary
In addition, all IdealScripts formulary programs can be fully integrated between retail and mail-service programs. Our cost-containment programs work equally well in retail and mail-order environments.
*Formulary Management may not apply to every plan. If you have questions about your drug plan coverage please contact Customer Service at 800.717.6614
top of page
Mail-Order Service is offered through Walgreens’ mail-order pharmacy, providing convenient home delivery of maintenance medications from three state-of-the-art mail-service pharmacy facilities.
- Online Refills
This is a convenient way for members to refill their prescriptions with this mail-order feature, 24-hours-a-day, seven-days-a-week. Most prescriptions are shipped within 24 hours of receipt.
- New Prescription Orders
Registered members with our mail-order service partner can mail in new prescriptions or have their doctors submit a Fax Prescription Order Form.
- Mail Service Forms
Initial member information packets include Prescription Order Forms for the convenience of members.
top of page
Clinical Management programs are designed to optimize patient health by educating patients and promoting compliance within recognized treatment guidelines. Ensuring that patients are on the right drug at the right time for the appropriate duration is the key to optimizing healthcare outcomes. Prior Authorizations, Step Therapy Programs, DAW (Dispense as Written) and ongoing monitoring strategies are essential to observe clinical program performance.
top of page
Our goal is to help clients effectively manage prescription costs and quality of care. IdealScripts provides clients with reports which detail access trends, potential problems and target areas for intervention.
Reporting is an essential tool in developing strategies to comprehensively manage pharmacy benefit programs. IdealScripts provides reports to assist decision-making in the following areas:
- Claims Activity
- Cost Savings
- Drug Utilization
- Therapeutic Class Analysis
- Trend Management
- Generic Strategies
top of page
|