Like most people, you probably don’t know much about the inner workings of pharmacy benefits management. But if you have health insurance, one of these organizations has a good chance that your prescription drug coverage is provided.
A pharmacy benefit management company (PBMC) is a third-party administrator of prescription drug programs for health insurers, self-insured employer groups, and government agencies. PBMs use their buying power and negotiating clout to get discounts from drug manufacturers and pharmacies. They also develop and manage pharmacy networks, process and pay prescription drug claims, and provide other services to their clients.
Here are five ways a PBMC can help you:
- Get the Best Possible Price on Your Prescriptions
Pharmacy benefit managers, also known as PBMs, are third-party organizations that manage prescription drug benefits for insurance companies, employers, and other clients. PBMs use their negotiating power to get discounts from drug manufacturers and pharmacies. They pass some of these savings on to their clients through lower copays or coinsurance. In addition, PBMs may also offer other services such as mail order prescription delivery and formulary management. As a result, PBMs can play an essential role in providing affordable access to prescription drugs.
- Access to a Pharmacy Network
Pharmacy benefit managers (PBMs) are third-party administrators of prescription drug programs for private insurance companies and government health plans. PBMs are responsible for processing and paying prescription drug claims and negotiating discounts and rebates with pharmacies on behalf of their clients. PBMs have an extensive network of pharmacies they contract with, giving plan members more choices when filling their prescriptions. In addition, PBMs often offer mail-order pharmacy services, which can be convenient for patients who take multiple medications or live in remote areas. By working with a PBM, patients can be assured that they will have access to the prescriptions they need at a reasonable price.
- Convenient Mail-Order Service
Mail-order pharmacies are becoming increasingly popular, and for a good reason. They offer a convenient way to fill prescriptions without going to the pharmacy. Many PBMs now offer a mail-order service, so you can have your medications shipped right to your door. The process is usually pretty simple: you need to sign up for an account with the PBM, and then you can start ordering your medications. Most PBMs will also offer discounts on shipping for orders of multiple drugs. So if you’re looking for a convenient way to fill your prescriptions, check out the mail order services offered by your PBM.
- Easy Claims Processing
Filing a claim for your prescription drugs can be a hassle. But if you use a pharmacy benefit manager (PBM), they can handle all the paperwork for you. PBMs are third-party administrators of prescription drug programs. They process and pay claims for the drugs covered under your plan. They also negotiate with drug companies on behalf of their clients to get the best prices. In addition, PBMs often offer tools and resources to help you make the most of your prescription drug coverage. For example, they may have a website where you can view your claims history and check the status of your claims. Or they may offer a mobile app that lets you refill your prescriptions and find the nearest participating pharmacy. Using a PBM can help to make filing claims for your prescription drugs easy and hassle-free.
- Customer Service Support
Pharmacy benefit managers (PBMs) are third-party administrators of prescription drug programs for commercial health plans, self-insured employer groups, union funds, and government agencies. PBMs are responsible for processing and paying prescription drug claims, negotiating rebates and discounts with drug manufacturers, and formulating and managing the pharmacy networks used by their clients. They also offer customer service support to help enrollees with any questions or problems they may have. In addition, PBMs can help enrollees find a pharmacy that is convenient for them. For example, some PBMs operate mail-order pharmacies that ship medications directly to enrollees’ homes. Others have developed mobile apps allowing enrollees to locate nearby pharmacies and compare prescription prices for specific drugs. By offering these types of services, PBMs can help make it easier for enrollees to get the medicines they need at a price they can afford.
If you have health insurance, there’s a good chance that a pharmacy benefit management company will provide your prescription drug coverage. These organizations use their buying power and negotiating clout to get discounts from drug manufacturers and pharmacies. They also develop and manage pharmacy networks, process and pay prescription drug claims, and provide other services to their clients. PBMs can help you get the best possible price on your prescriptions, access a convenient mail order service, and have straightforward claims processing.
