How We Help // Casualty Claims Solutions

Workers’ Compensation PBM

HealthSmartRx Solutions Workers’ Compensation Pharmacy Benefit Management

Reduce costs, manage drug utilization, and get employees back to work sooner

HSRx_WC_PBM_02_350x214.pngEach year there are nearly 3 million reports of employer-related injury or illness. Medications play an important part in getting many of these employees healthy and back to work as soon as possible. With the use of medication, however, comes potentially higher costs and over-utilization. With the current opioid crisis, the risks are higher than ever to both your employees and to your company.HSRx_WC_PBM_03.png

HealthSmartRx Solutions Workers’ Compensation Pharmacy Benefit Management Solutions helps employers keep costs down while managing appropriate drug use as part of an effective treatment plan. Injured employees will have convenient access to pharmacies across the country with the clinical oversight needed to assist in their recovery, as well as tailored educational support to get them back to work sooner.

For employers, we provide a consultative pharmacy benefit design to meet their specific needs. HSRx provides network and administrative and claims processing services, comprehensive reporting, utilization management strategies, and stringent security and quality management protocols in compliance with all state and jurisdictional requirements and regulations.

When facing workers’ compensation claims, working with HealthSmartRx Solutions to manage your pharmacy benefits is an effective strategy to control costs while getting their employees the effective, appropriate care they need to recover.

 

Ensure Quality Care

  • Comprehensive First Fill services and strategies to maximize program penetration.
  • Automatically embedded Official Disability Guidelines (ODG) in our standard workers’compensation formulary to help ensure that injured workers receive the safest and most appropriate treatment.
  • Qualified staff, including direct access to in-house pharmacists for consultation and support.

Manage Drug Utilization

  • Management of Drug Utilization at point of sale through customizable formularies.
  • Reliable pharmacy processing system with embedded security measures to avoid potential misuse and abuse.

Mitigate Risk

  • Risk scoring that may lead to the recommendation of drug screening, medication reviews, peer-to-peer interventions, and/or pharmaceutical peer reviews by authorized providers to ensure appropriate care.
  • Reporting and analytics to further predict high risk injured workers and reduce increasing prescription.

Reduce Costs

  • Early intervention to avoid long-term, high-risk, high-cost claims.
  • Leading compound and repackaged drug management solutions to further reduce pharmacy spend.
  • Ease of use with reduction/automation of workflow for adjusters, as well as online and real-time adjudication to streamline the decision processes.

Deliver Access

  • Largest workers’ compensation pharmacy network of more than 67,000 pharmacies nationwide.
  • PBM services to more than 150 national and regional Workers’ Compensation payors.