Pharmacy Solutions That Cut Costs — Not Corners

Our PriorityRx program provides immediate pharmacy

• Network discounts applied to first prescription immediately
• Flexible enrollment options: on-site and online portals
• Scalable workflow customizations to fit your organization
• Single-source invoicing for simplified administration

Access to the nation’s largest pharmacy network with comprehensive point-of-sale review and customizable options.

• 64,000+ locations including all national chains and independent pharmacies
• Client-specific custom network configurations available
• Real-time medication review before dispensing to prevent errors
• Customizable medication plans tailored to your workforce
• Comprehensive third-party bill review solutions

Convenient mail order pharmacy services with transparent pricing and fast delivery for maintenance medications.

• Manufacturer-leveraged pricing for maximum savings
• All medications screened for compensability before dispensing
• Early refill and quantity limit checks to prevent abuse
• Toll-free IVR order line for easy prescription refills
• 2nd-day delivery standard on all 90-day supplies

Specialized compounding services that work directly with treating providers to deliver custom medications at reduced costs.

• Direct collaboration with treating physicians to determine optimal formulations
• Source high-quality ingredients at competitive prices
• Significant cost savings compared to retail compounding
• Quality assurance and compliance with all regulatory standards

Advanced formulary management tools that give you granular control over medication approvals and utilization.

• Customizable drug lists at the individual claimant level
• Preferred drug list (PDL) development and maintenance
• Step therapy protocols to encourage cost-effective alternatives
• Regular formulary reviews based on clinical evidence and cost data
• Exception processes for medically necessary non-formulary drugs

Comprehensive point-of-sale review system that catches potential issues before medications are dispensed.

• Real-time medication verification at the pharmacy counter
• Drug-drug interaction screening for patient safety
• Duplicate therapy checks to eliminate waste
• Dosage validation against clinical guidelines
• Immediate alerts for non-compensable or off-label prescriptions

Comprehensive utilization management programs designed to reduce costs while maintaining quality care.

• Generic Conversion: Automatic substitution to lower-cost generic equivalents
• Narcotic Management: Opioid monitoring and control programs
• Pharmacotherapy Case Management: Personalized medication therapy management
• Quantity Limits: Controls to prevent overutilization
• Prior Authorization: Medical necessity review for high-cost medications
• Non-Injury Drug Use: Detection and prevention of unrelated prescriptions
• Off-Label Drug Use: Review of medications used outside FDA approvals
• Physician Profiling & Education: Provider feedback and best practice guidance

Clinical pharmacist-led interventions that work with providers and patients to optimize treatment plans.

• Proactive outreach to prescribers for high-cost or questionable medications
• Medical necessity assessments by licensed clinical pharmacists
• Evidence-based alternative therapy suggestions
• Patient counseling and education on medication adherence
• Collaborative care approach with treating physicians

Aggressive third-party bill review and elimination process that delivers industry-leading savings.

• Proprietary bill elimination process, not just repricing
• Average savings of up to 75% on physician-dispensed medications
• Detailed audit of physician dispensing practices
• Repackaging detection and cost recovery
• Compliance monitoring and fraud prevention