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What To Look For In A Pharmacy Benefits Administrator

Pharmacy Benefits Management is often opaque and convoluted, but it doesn’t have to be. While other pharmacy benefits administrators play games with your benefits, RxPreferred provides true transparency, a zero conflict-of-interest strategy, and fully-customizable solutions. 

Traditional pharmacy benefits administrators tend to take advantage of clients and their members. The Pharmacy Benefit Manager (PBM) Games video illustrates the problems that can arise when there are conflicts-of-interest.  

Expect More From Your Pharmacy Benefits Administrator

Transparency is crucial in deciding the right partner. The following questions need to be asked when looking for a pharmacy benefits administrator partner to ensure you don’t spend more than you should. 

At RxPreferred, we charge our clients the actual cost of each prescription, with no markups. What we pay the pharmacy is what we bill our clients.    

At RxPreferred, our clients have access to real-time information that validates what we paid the pharmacy on their behalf. Without this visibility, there is no way of knowing if a PBM has overcharged.

PBMs that own mail order or specialty pharmacies can influence pricing. RxPreferred believes this is a conflict-of-interest; therefore, we do not own any pharmacies. Instead, we save money for our clients by allowing 90-day prescriptions at retail pharmacies and leverage third-parties to drive the best pricing when mail and specialty items are needed.

One hundred percent of all rebates received by RxPreferred are given directly to our clients.

At RxPreferred, our only source of revenue is our flat, per claim, administrative fee. We have no hidden revenue sources.  

Why should you select RxPreferred as your Pharmacy Benefits Administrator?

Our customized solutions give you the visibility you need into drug coverage, rebates, and network discounts so you can effectively manage your plan. We are confident that once you have asked the questions above, you will see the obvious benefit of working with a fully transparent pharmacy benefits manager that values accountability and puts client interests first.

Got Questions about Pharmacy Benefits Management?

Groups that are new to the pharmacy benefits management industry often have questions regarding terms, benefits, and what the process looks like. Below are the most frequent questions asked to our advisors.  

After the complete claim file is received, a detailed analysis is produced within ten (10) business days. 

All we need is your pricing claims file. You can find a sample of the items under our ‘Resources’ tab. Your broker, TPA, or current PBM can provide this within 24 hours.

Employers get lost in the crowd with large PBMs. RxPreferred gives you the best of all worlds: the capabilities and competitive discounts of a first-in-class PBM coupled with our proprietary services and technology. With our program, you have your own account management team, customer service, analysts, and billing support. We work with you for visibility and understanding of your benefits.

This means the prescription benefit is separated from the medical benefit and managed by a different provider. Historically, employers have trusted a health insurer to manage both medical and prescription benefits. Today, the trend for self-insured employers is to carve-out the pharmacy benefit and contract directly with a company like RxPreferred.

  • Real-time access to see exactly what we paid the pharmacy on your behalf
  • Transparency and understanding of the financial aspects of your pharmacy program
  • Control over the plan, including the ability to customize your plan
  • Cost management and awareness of healthcare spend
  • Adherence to drug regimens with clinical tools and 90-day purchase options for impvorved healthcare outcomes
  • Access to the industry experts regarding all aspects of pharmacy benefits, including formulary, networks, utilization management, regulatory compliance, and other clinical programs
  • Leverage with innovative solutions pertaining to pharmacy benefits

Have more questions?

Speak to a trusted advisor who will answer any questions you may have. Expect more from your pharmacy benefits administrator. 

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