Workplace injuries are certainly bad news for you and your employees. Point-of-care medication dispensing can lead to a quicker employee recovery, less medication dispensed throughout the duration of the claim, fewer unnecessary procedures and an earlier return to work. This not only benefits the injured employee, it also benefits the employer who is tasked with managing healthcare costs while ensuring business demands are still met. It is in everyone’s best interest to get the injured worker back on the job as soon as possible. Point-of-care medication dispensing improves the quality, timeliness and cost-effectiveness of health care in today’s workers’ compensation market.
The sooner an injured worker starts receiving proper medical treatment, the earlier he or she can get back to work and the less time an employer needs to find additional assistance to cover the injured employee’s workload. AHCS works hand-in-hand with stakeholders to make it easier for patients to obtain their medications immediately which accelerates their road to recovery.
Physicians often dispense the same formulary of medications as pharmacies, with the cost-saving benefit of generics where possible. AHCS can work within all formularies determined by an employer, a third-party administrator (TPA) or a pharmacy benefits manager (PBM) to further effectuate desired cost-savings. AHCS can also electronically submit prescription bills for the physician, streamlining the process for everyone.
AHCS works with TPAs to make sure prescription medication claims are appropriately processed. We work with each TPA’s pharmacy benefits managers and clients to create a program that will electronically follow protocols at the point of care, as set forth by the individual clients. AHCS can easily implement individualized programsfor each client.
The use of electronic processing of prescription medication claims through the PBM or bill review process allows TPAs to analyze pharmacy costs on a client-by-client basis through our batch processing solution.
Through our processes, TPAs can identify hard savings through AHCS’ negotiated national contracts. This enables TPAs to effectively demonstrate meaningful results to their clients.
AHCS continues to enter into strategic partnerships with many carriers and PBMs throughout the nation. AHCS can work directly with your PBM to foster cost savings and streamline your processes.
AHCS has established a provider network across the country, with agreements in place to ensure that the costs associated with physician dispensed medication are reasonable and appropriate for the marketplace.
Our claims processing system can be seamless and paperless, utilizing the electronic transfer of information to expeditiously process prescription medication claim information.
PHARMACY BENEFITS MANAGERS
A key to the success of the AHCS model is to work closely, and in tandem, with the stakeholders in the workers’ compensation arena, including PBMs. AHCS is establishing relationships and contracts with many of the nation’s largest PBMs, and the result is competitive cost- savings for prescription medications and proper state reporting (if applicable).
PBMs particularly benefit from electronic billing that is a part of the AHCS process. AHCS has the capability to transmit prescription medication claim information electronically through HL7, 837, ANCI 5010, or via other requested formats, thereby eliminating manual processes for the PBM and reducing overhead costs.
AHCS’s program allows PBMs to designate formulary parameters and other rules to effectuate client cost-savings.