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RxReference℠

What Products Does RxEOB Make?

Product Bubbles

Member Engagement & Reporting

MYDRUGBENEFIT MERCURY MESSAGING RXMONITORRXREFERENCE

Workflow & Web Service Delivery

AUTOAUTHRX RXFORMULARY COSTAVOIDTPL RXDATAETL

MyDrugBenefit®

PERSONALIZED MEMBER PHARMACY INFO PORTAL

I’m never prepared well for my doctor’s appointment but my pharmacy benefit portal allows me to simply print my medication history and other personal health information to give to any doctor I’m scheduled to see.

Portal benefits for members:
  • Increases member satisfaction with personalized medication savings and benefit summary information.
  • Increases awareness of network pharmacy options and potential drug-drug interaction concerns.
  • Decreases costs through easy-to-use drug look-up and therapeutic alternatives with pricing for both retail & mail order.
  • Reduces labor costs through efficient member messaging channel and plan resource links for self-service.

emWellics®

PERSONALIZED MOBILE PHARMACY BENEFITS APP

Because I have a high deductible for my health insurance, I can find ways to save on my medication purchases. I just type the drug name and I get a listing of medication options based on my pharmacy benefit, with savings calculated for each drug.

Application benefits include:
  • Fast to market through configurable application modules
  • Increases patient satisfaction through personalized medication savings detail
  • Increases sponsor savings through pharmacy network promotion
  • Reduces staff costs with an efficient messaging channel
  • Enhances compliance profile with Star Ratings, Meaningful Use, and HEDIS measurement initiatives

Mercury Messaging℠

MEMBER MESSAGING SERVICE & PLATFORM

I don’t go anywhere without my smart phone so if my insurance company wants to offer me reminders to refill my medications or wants me to use a different pharmacy, the best way to reach me is with a text message.

Service benefits include:
  • Member values concise and accessible information
  • Increased member reach & faster response rates
  • Enhanced member experience and satisfaction
  • Reduced Medicare & Medicaid costs
  • Higher reimbursement from improved Medicare Star Ratings

RxMonitor®

DRUG UTILIZATION ANALYSIS & REPORTING

Since we have members with Commercial, Medicare, and Medicaid benefits, we get to compare prescription utilization by line of business, by group account, and by member. We also get physician prescribing information as well as care management reports identifying patients at risk or who need adherence support.

Reporting features include:
  • Member-specific drug utilization detail
  • Brand & Generic drug market share by class, patient condition, and prescriber
  • RxPMPM cost comparisons by line of business and by group accounts
  • Exportable data and analysis reports
  • Secure application access privilege options

AutoAuthRX℠

E-PRIOR AUTHORIZATION APPLICATION

I don’t understand why my doctor gives me a prescription for a drug that the pharmacy says needs prior approval from my insurance company. Don’t they realize I don’t have extra hours to hang around the drug store waiting for everyone to agree?

App benefits to plan and patient:
  • Reduced labor costs for physician and plan/PBM through e-PA submission, review, and determination.
  • Increases adherence with prescribed medications by reducing delays at the POS / retail pharmacy.
  • Higher margin for plans / PBMs that charge for PA service through lower processing costs.
  • Reduces compliance audit headaches through structured reporting of timelines for all PA processing activities.

RxFormulary℠

ENTERPRISE-WIDE FORMULARY MANAGEMENT APP

Because we have many different formularies across various lines of business, we need a centralized way of reviewing and changing formularies based on different pharmacy benefit coverage decisions and plan designs.

APP CAPABLITIES INCLUDE:
  • Configurable formulary application for consolidating all Commercial, Medicare Part D, and Medicaid formularies.
  • Formulary export functions for reporting to Federal, State, and HIX entities.
  • Schedule formulary changes and integrate directly with claims processors.
  • Access and approval safeguards.

CostAvoidTPL℠

DAILY ANALYSIS SERVICE FOR FINDING MEDICAID OHI

Rather than recovering less that 10 cents for every dollar spent on third party liability efforts, we’d rather avoid future managed Medicaid claims by auditing member eligibility everyday using their Medicaid pharmacy claims.

SERVICE BENEFITS INCLUDE:
  • Prepayment identification of Medicaid users with Other Health Insurance (OHI)
  • Captures savings for both pharmacy and medical OHI segments
  • Four times the coverage segments identified versus traditional COB
  • Free evaluation of OHI within Medicaid pharmacy claims and “No Risk” business model

RxData ETL℠

WEB SERVICE DELIVERY OF MEDICATION PRICING

We need our prospective Medicare Part D patients to know what drugs cost whether or not they are covered on our formulary and commercial members with high deductibles want accurate drug pricing as they shop network drug stores.

Service benefits include:
  • Faster time-to-market via API between customer and RxEOB for medication pricing analytics (using member pharmacy benefit and formulary).
  • Increases credibility from pricing based on analysis of more than 45 million patient pharmacy claims.
  • Enhances member experience through integration of personalized data into preferred communication channels.

RxReference℠

MEDICATION PRICING TOOL

I have a high deductible insurance plan so I pay for my prescriptions. I need a way to see how much these drugs cost and if there are any other drug options for me at lower prices.

SERVICE BENEFITS INCLUDE:
  • Increases AWARENESS and TRANSPARENCY to the user for how much medications typically cost to guide them in their purchase planning.
  • Enables user to see other therapeutic options and related pricing to help them purchase with better information.
  • Increases understanding of the side-effects and medication use information for each drug researched.