What evolution in CLAIMS PROCESSING/ DRUG BENEFIT ADMINISTRATION needs to take place?

[Pharmacy Technology Resource, LLC]

IF YOU could design a system - how would YOU make it better?

A claims processing system is supposed to provide a flexible, cost
effective and real time solution for drug benefit administration. The
system should receive, approve, and deny claims; create payments to
pharmacies and patients; and remit statements and explanation of
benefits.

Specific functions should be included:

Claims Adjudication
Formulary Management
Patient Eligibility/Membership Maintenance
Drug Utilization Review
Management Reporting
Network Management
Provider Reimbursement

The System needs to be flexible due to the use of table-driven menus
for plan administration which permits plan changes without computer
programming or delays in implementation.

What's missing?

What does the INDEPENDENT PHARMACY NEED a system to do - beyond these
features?
How can we help your pharmacy be more profitable?

Please let us know: part...@pharmacytechnology.net
www.pharmacytechnologyblog.com
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