What We Offer

Our team reviews and analyzes each medical and specialty drug claim whether in-network or out-of-network to develop strategic, patient-centric options that maximize your organization’s cost savings.   We perform a comprehensive clinical, pharmaceutical, billing and coding review of each claim and work alongside your case management team when applicable.

All claims receive the same high-level of detailed review to obtain the maximum evidence-based savings.  After review and approval from our client, we proceed with our unique approach to negotiation that includes a provider sign-off on every agreement and a strong, continuous provider relationship.

Each specialty drug claim is reviewed for proper coding including diagnosis, treatment, administration, supplies, and price appropriateness. Our team will provide you with estimate of evidence -based cost savings based on strategic options which may include:

1. Transfer of patient prescription from current provider to new specialty drug provider
2. Set up new or current patient for home infusion or at ambulatory infusion center
3. Negotiate with current specialty drug provider whether pharmacy, outpatient clinic, or physician’s office

We take care of all steps for the option you choose ensuring that the process is seamless for the patient and your organization.  As healthcare professionals ourselves, we are committed to ensuring our options are patient-centric while providing your organization’s maximum specialty drug cost savings. 

We obtain the optimal pricing from our provider network of specialty pharmacy providers. We evaluate each patient’s needs for specialty drug pharmacy disease management teams to provide additional educational resources and support for patient compliance.  We review each patient’s benefits for preservation and to find financial assistance in the case of high-dollar deductibles, co-insurance and co-pays.