Pharmacy Benefits Manager Services

The Vendor is required to provide pharmacy benefits manager to work in conjunction with its health care providers to serve its employees and their families.
- Capability and item
•    Drug cost comparison, by specific retail pharmacy location
•    Formulary lookup by drug name
•    Full formulary listing
•    Member's historical claims information
•    Retail pharmacy locator (sorted by distance)
•    Savings recommendations (delivery channel alternatives)
•    Savings recommendations (drug alternatives)
•    Savings recommendations
•    Savings recommendations (therapy cessation)
•    Temporary id card
•    Drug cost comparison, by specific retail pharmacy location
•    Formulary lookup by drug name
•    Full formulary listing
•    Member's historical claims information
•    Retail pharmacy locator (sorted by distance)
•    Savings recommendations (delivery channel alternatives)
•    Savings recommendations (drug alternatives)
•    Savings recommendations 
•    Savings recommendations (therapy cessation)
•    Electronic id card
•    Telephone
•    SMS and MMS
•    Letter
•    Email
•    Mobile app
•    Web portal
•    Age and gender-related contraindications
•    Clinical abuse and misuse
•    Drug-allergy contraindications
•    Drug-drug interactions
•    Dual tracking for early refills that identify both current and cumulative usage and accounts for claims dispensed across, retail, mail and other pharmacy distribution channels adjudicated through your system.
•    Food allergy contraindications for medications
•    Incorrect drug dosage or duration of drug therapy
•    Over-utilization and under-utilization
•    Potential drug therapy problems due to therapeutic duplication
•    Identify over- or inappropriate prescribing by doctors
•    Identify potential abuse patterns by a member
•    Identify potential fraud by pharmacies.