The Pharmacy Benefit Management strategic partners offer a variety of services to assist PACE organizations with the management of Part D benefits. These include the following:

  • pharmacy network contracting;
  • prescription drug claims processing and adjudication;
  • rebate submission and payment;
  • TrOOP (True Out Of Pocket costs) reporting;
  • support in implementing the PACE organization Part D compliance and Fraud, Waste and Abuse Program;
  • assistance in complying with CMS Part D reporting requirements;
  • prescription drug event submission and reconciliation;
  • pharmacy help desk administration; and
  • management and utilization reporting.
     

Pharmastar offers a range of services specially tailored to meet the needs of the PACE industry. With over 20 years of experience, Pharmastar administers pharmacy benefits for a wide variety of clients throughout the country. Pharmastar offers customized pharmacy network solutions, as well as access to a national network of over 64,000 pharmacies.

We offer the following services:

Clinical Services

  • Pharmacy Access
  • PACE-Specific P&T Discussion Forum
  • DUR Programs
  • MTM Program Development Support
  • Access to Clinical Pharmacist
  • Clinical Pharmacist-Led Utilization Review

Clinical Reports

  • Beers
  • Poly Pharmacy
  • Psycho Tropics
  • Opioid Utilization
  • Acetaminophen Utilization

Administrative Services

  • PDE Management
  • P2P Management
  • Government and State-Level Reporting
  • TrOOP Support
  • Non-Standard Programming
  • DIR Rebate Administration
  • Claims Processing
  • Analytics

Administrative Reports

  • B vs. D Determination Report
  • ESRD Support
  • Executive Summary
  • PDE Full File
  • High Cost

Contact

 

SeniorScript logo

SeniorScript is a clinically focused pharmacy management company that specializes in the specific needs of frail and elderly individuals, addressing all pharmacy-related health plan management functions. SeniorScript systems and software have been customized to allow greater control in adjudicating claims for complex patients, managing specialty pharmacy networks, and providing data in a manner and format that allows for timely action.

SeniorScript offers the following features and benefits:

  • Manage Cost Trends: We take a total health care value approach to building and maintaining pharmacy benefits to proactively manage trends in formulary management, clinical programs, utilization management programs, specialty pharmacy, home delivery and retail networks.
  • Drive Medication Adherence and Quality Care: Our clinical care programs improve safety and optimize member health through monitoring and engagement. A range of clinical and utilization management strategies help ensure safe medication use, improve formulary adoption, and promote cost-effective treatment options.
  • Proactively Engage and Support Members: Every member interaction represents a chance to make a difference in member health and total health care costs. Our innovative 360 Opportunity Alert System connects data to highlight engagement opportunities that can help members save money and improve health outcomes.

Contact

There are more than 240 PACE centers in 31 states. Find your local PACE program.

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