Prescription Benefit Management

Prescription Benefit Management
Universal Rx managed prescription benefit plan will reduce annual health care costs by 18-21%

Universal Rx is committed to improving both pharmacy benefits and overall medical conditions for all Clients’ plan members. A leader in pharmacy benefit management, Universal Rx has developed sophisticated and proprietary pharmacy data management tools to enhance overall benefits at the lowest possible cost. With our extensive experience in managing pharmacy benefits, Universal Rx captures and evaluates data on every prescription benefit encounter to provide a comprehensive illustration of drug utilization trends in the industry. Through optimal plan design, Universal Rx can support clients’ efforts to achieve all of its pharmacy benefit plan goals for plan members. Universal Rx uses pharmacy data management to provide sophisticated reporting mechanisms aimed at:

  • Building and maintaining cost effective prescription benefit plan designs.
  • Designing and developing customized formularies and preferred drug lists for appropriate drug therapy.
  • Developing plan member prescription adherence and compliance programs aimed to improve outcomes in order to make participants happier and healthier.

Administration & Reporting

Universal Rx provides each client with Account Management Teams comprised of Managers in the areas of Accounting, Customer Service, Plan Design, Contracting and Business Development are assigned to oversee each account. Our Account Management Teams maintain a 99.8% success rate of incoming calls answered before a call goes into wait mode. This means only 0.2% of incoming calls experience a waiting time before their call was answered. The average wait time for this 0.2% of incoming calls is 14 seconds.

Third Party Administrators (TPAs)

In today’s industry, it is common for groups to have third party involvement. Universal Rx is accustomed to coordinating and providing data such as eligibility, claims utilization data and reporting to other sources assisting in the administration of the group’s plan.

 Eligibility

Universal Rx offers access to real time eligibility lists through an online reporting warehouse to TPAs and their Clients.

 Plan Design

Universal Rx provides TPAs with information pertinent to the group’s plan design. This information includes co-payments, deductibles, maximums, covered and non-covered items, day supply limits, mail order pharmacy information, diabetes management program information and information pertaining to the EPS program.

Reporting

Currently Universal Rx offers both TPAs and their Clients online access to approximately 60 different reports. This ensures data is readily available when needed.

HIPAA Compliance

Universal Rx has long made it a practice to safeguard the confidentiality of the personal health information of its clients’ members. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 has advanced this effort by implementing privacy standards throughout the healthcare industry.

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