by Karen Apwah | Sep 18, 2023 | Electronic Prior Authorization, Prior Authorization
Pharmacy Benefit Managers (PBMs) play a pivotal role in ensuring access to cost-effective, quality treatments for self-funded employers and their members. One PBM stood out for its commitment to transparency and advanced clinical management, but they faced a challenge...
by Karen Apwah | Aug 31, 2023 | Electronic Prior Authorization, Prior Authorization
In the ever-evolving landscape of healthcare, streamlining processes while ensuring compliance is crucial to delivering efficient patient care. One significant challenge that has long plagued the healthcare industry is the manual and time-consuming process of...
by Karen Apwah | Aug 8, 2023 | Electronic Prior Authorization, Prior Authorization
In the dynamic realm of healthcare, striking a balance between providing optimal care for members and maintaining operational efficiency is a constant challenge. For Health Plans and Pharmacy Benefit Managers (PBMs), the ability to exercise flexibility and control in...
by Karen Apwah | Jul 31, 2023 | Formulary Benefit Design
In today’s dynamic healthcare landscape, Health Plans and Pharmacy Benefit Managers (PBMs) play a pivotal role in ensuring that patients have access to safe, effective, and affordable medications. One of the essential tools in this process is the formulary—a...
by Karen Apwah | Jul 24, 2023 | Medication Therapy Management
For Health Plans and Pharmacy Benefit Managers (PBMs), ensuring CMS compliance is essential to the success and effectiveness of their Medication Therapy Management (MTM) programs. Meeting these guidelines not only guarantees the provision of quality care but also...
