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Personalized and evidence-based clinical programs

Benecard's clinical organization creates customized clinical management programs based specifically on your client's demographics and claim history. The basis of our recommendations is always solid data analytics coupled with decades of experience in creating and delivering effective clinical programs. The goal of our clinical programs is to achieve the lowest net cost while remaining consistent with the highest standards of evidence-based medical practice.

Our in-depth analysis identifies:

  • Patient, prescriber, and pharmacy patterns
  • Member safety issues
  • Cost saving opportunities
  • Personalized impact of drug pipeline

After analyzing your client's plan information, we formulate a personalized program for your client that will:

  • Control claim costs
    • Prior authorization
    • Medication quantity control program
    • Specialty pharmacy
    • Starter dose
    • OTC coverage
    • 90 days at retail
    • Dose Optimization
    • Compliance and polypharmacy program
  • Impact patient health and safety
    • Concurrent drug utilization review (DUR)
    • Retrospective drug utilization review (DUR)
    • Clinical edits including ICD-9
    • Recall notifications
    • E-Prescribing
    • Fraud and abuse control
  • Keep their members healthy
    • Disease-specific health management - RxTrainer level 1, 2, 3
  • Increase generic utilization
    • Member-specific interventions
      • Clinical cost management programs
      • Therapeutic substitution
      • EOB
    • Custom generic messaging at point of sale
    • Step therapy
    • Personalized medicine test kits
    • Zero dollar co-pay for generics
    • Physician practice pattern analysis / communications
    • Generic alternatives and pricing comparison online, you must be logged into to compare pricing
    • E-Prescribing
    • Therapeutic MAC

Benecard - evidence-based clinical management personalized to your client's unique needs.

Last Updated Tuesday, October 22, 2019 - 09:14 PM.