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PRAM
PRAM was originally founded in 1989 as an Underwriter and a Registered Administrator with corporate headquarters located in the City of Brea in Orange, California and today has offices in Chicago and throughout the US. PRAM provides Pharmacy Consulting, Underwriting and Employee Benefit services to local, regional and national accounts.
Pharmacy Consulting Services
- Pharmacy benefit design support, backed by one of the most sophisticated predictive modeling systems available that ensures clients will know what to expect in terms of trend and enable them to budget accordingly.
- Operations and technical support experienced in managing and administering online pharmacy plans.
- Full Risk and Profit sharing programs for clients seeking fully insured options
- Specialty Pharmacy and Bio Tech programs
- PBM comparison studies to provide clients with information on which PBM really has the lowest net cost.
- PBM Audits
Underwriting Services
The following lists the types of fully insured pharmacy carve-out plans that PRAM underwrites currently:
- Employer Groups
- Seniors - Retirees
- Generic Only Products for Limited Benefit Programs
- Insured Programs sold with Medicare Supplement Programs
- Association Programs
- State and Local Government Programs
- Pure Fronting arrangements
We believe our experience in all aspects of Risk Management Consulting, including the understanding of Pharmacy Risk with the support of Staff Pharmacists will add value in providing strategic planning in a growing complex industry. Our goals are to help our clients understand and manage issues relating to medical and pharmacy claim cost while providing leading edge technology to analyze options that will have a positive impact on rising trends while balancing the needs of appropriate therapy.
PRAM's Underwriting Staff and Pharmacy team brings years of experience in working with many of the nations leading insurance companies, national consultants, pharmacy benefit managers, and employer groups. This experience is passed on to our clients to facilitate the decision making process and provide solutions to complex issues.
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Career Opportunities!
RXinsider’s Virtual Job EXPOs are the perfect online destination for healthcare practitioners seeking to research and connect with leading healthcare employers throughout every practice setting. Hundreds of healthcare employers, thousands of jobs, all in one convenient location!
RXinsider currently offers Virtual Job EXPOS for the following healthcare disciplines:
- Pharmacy
- Nursing
- HIT/HIM/Informatics
- Therapy/Allied
- Healthcare
Advertising Opportunities:
Attracting more than one million visitors annually, RXinsider’s Virtual Job EXPOs are an excellent venue for employers to post career opportunities, brand their organizations, and connect with healthcare professionals throughout multiple disciplines.
Our unique Job EXPO format allows employers to not only address acute needs, but develop a proactive strategy for future needs. Please contact an RXinsider Sales Representative for advertising information: http://rxinsider.com/advertise.htm
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Long term care pharmacy Nuclear / Radiopharmacy Long Term Care / LTC Clinical Hospital / Health System Home Infusion Temporary and Per-Diem Staffing Pharmacy Benefit Management / PBM Managed Care Telepharmacy Medical Science Liaison / MSL Specialty Pharmacy Management & Consulting Independent Community / Retail Chain Community / Retail Mail Order
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WellPoint Next Rx
Making benefits smarter.
WellPoint NextRx is a progressive pharmacy benefit manager (PBM) helping health plans, employer groups and third party administrators target the reduction of total health care costs and improve health outcomes. Pharmacy benefits present unique challenges: breakthrough medications, increased utilization, an aging population. In the face of so many dynamics, WellPoint NextRx has smart solutions.
Total package.
NextRx provides all of the standard PBM services that clients expect. This includes claims processing, clinical and disease management programs, retail network, mail and specialty pharmacy, customer service, and rebate management. With roots that date back to the 1980’s, NextRx has years of experience in providing these fundamental services.
NextRx will help lead the industry into a new direction. How? By providing the products clients need to make their clients and members happy, healthy and well informed. And by helping members get the medicines, treatments and information they deserve.
Those looking to get more from their pharmacy benefits program – in dollars and in health – turn to WellPoint NextRx. Effective pharmacy programs. Lower net costs. Results all around.
1-800-451-0433
www.wellpointrx.com
www.anthemprescription.com
WellPoint NextRx is a Service Mark of WellPoint, Inc. Services are provided by a WellPoint PBM (either Professional Claim Services Inc., doing business as WellPoint Pharmacy Management, or Anthem Prescription Management, LLC, as appropriate). WellPoint NextRx is a division of WellPoint, Inc.
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Emdeon
Emdeon - Solutions that Simplify the Business of Healthcare for Providers, Payers, and Channel Partners.
Emdeon provides revenue and payment cycle solutions that connect payers, providers and patients to integrate and automate key business and administrative functions throughout the patient encounter. Through the use of our comprehensive suite of products and services, our customers are able to:
- improve efficiency
- reduce costs
- increase cash flow
and more efficiently manage the complex revenue and payment cycle process.
Emdeon is a leading provider of prescription benefit administration solutions that enable managed care organizations, prescription benefit managers and other healthcare payers to improve claims processing efficiencies and better control prescription drug costs. Building on our decades of experience, we provide pharmacy claims adjudication, data warehousing and ancillary administrative services that enable our clients to improve claims processing efficiency, attain total financial transparency and better control, prescription drug costs. Our easy-to-use, Windows-based system streamlines implementation and maintenance of your Prescription Benefit Programs. And because an efficient Benefit Program requires more than just routine business intelligence, Emdeon SelectRx Insight offers you the timely, dynamic, and secure clinical and financial reporting that your business demands.
Emdeon provides the systems infrastructure as well the administrative support necessary to allow payers to effectively manage their prescription benefit program in-house. Emdeon’s award-winning, flexible claims processing system supports complex benefit designs, multiple networks, and client-owned contracts.
Just tell us what you need. Emdeon can tailor our services to provide as much assistance as your organization needs:
- Our core service is pharmacy claims adjudication and data reporting
- We can provide transparent call center support for member and pharmacy calls
- We encourage and assist our clients in negotiating their own Retail Pharmacy Networks and maintain a MAC list while we handle the network administration
- We encourage our clients to hold their own Drug Manufacturer Rebate Contracts while providing them with additional clinical support and the drug manufacturer contract management tool to reconcile rebates with the manufacturers.
Pharmacy Claims Adjudication - The state-of-the-art SelectRx system offers a cost-effective alternative to the task of operating and maintaining an in-house pharmacy claims adjudication system.
Includes:
- SelectRx Insight - Web-based, ad hoc reporting tool, SelectRx Insight, provides a clear window into the clinical and financial information pharmacy benefit managers must use on a daily basis.
Flexible, customizable add-ons
- Rebate Management - Provides a secure, web-based manufacturer rebate management system with exceptional decision support capabilities that calculates, invoices, and reconciles rebates electronically for all manufacturers
- Network Administration - Fully supports client-negotiated retail pharmacy network contracts, but also maintains our own nationwide network of participating NCPDP licensed pharmacies.
- Customer Service Call Centers - Tapping nearly 20 years of Pharmacy expertise, Emdeon offers health plans exceptional solutions for outsourcing pharmacy and member call support that can save money and provide transparent staff extensions.
To experience how simple managing your prescription business could be, contact an Emdeon professional today.
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Emdeon Healthcare Information Systems and Healthcare Software, Emdeon Healthcare Solutions and Medicare DDE and Medicare Secondary Billing, Emdeon Online Bill Presentment and Patient Access Management, Patient Benefits, Patient Eligibility, Patient Friendly Billing, Patient Receivables, Patient Registration, Payment Posting, Revenue Cycle Management, Secondary Claim Processing and Verify Patient Information by Emdeon
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Medco
Medco is a leading pharmacy benefit manager (PBM) with the nation's largest mail order pharmacy operations. Medco assists its customers to moderate the cost and enhance the quality of prescription drug benefits provided to members nationwide. Ensuring that millions of Americans have access to affordable, high quality prescription healthcare is more than our business - it's our calling.
Every day, our employees dedicate themselves to bringing:
- Better Care
- Better Value
- Better Service
When your health plan or employer chooses Medco for prescription benefit coverage, you can be confident you're receiving the best care and service available. But we don't just safeguard the quality of your prescriptions. We work hard to provide you with information to help make informed decisions about the cost of your medications and available alternatives for you and your healthcare provider to consider. This includes information about savings that may be offered through our mail-order service or about the use of clinically-appropriate generic drugs.
And we are a company that never stops trying to do it better. At Medco, good has never been good enough. We've always been at the forefront of the industry - in knowledge, innovation, technology, and in pioneering new products and services. You can count on us to continue to be a catalyst for positive change because, at Medco, we never stop trying to do it better.
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