Commercial and Medicaid Pharmacy Benefit Management »
Worker’s Compensation Claims Management »
Nurtur™ Health Management »
Coordination of Benefit Solutions with HD-RX »
Pharmacy Benefit Management for County Healthcare »
Serving the Needs of the MHMR Community »
Patient Assistance Program (PAP) Management System »
RX Advantage Discount Card Program »

Commercial and Medicaid Pharmacy Benefit Management[back to top]

US Script is a full service PBM dedicated to delivering custom solutions and one-on-one service. US Script’s solutions are built on seasoned clinical expertise, proactive education programs, customizable technology, and a customer support team that listens and gets results. US Script offers a complete package of benefit management solutions including:

» One-on-one consulting services

» Tailored plan designs to meet your needs

» Ease of access to information through online and custom reports

» Integration of medical and pharmacy claims data

» Member support through attendance at enrollment and health fairs

» 24/7 help desk -- reach a live representative in 30 seconds or less

Worker’s Compensation Claims Management[back to top]

The fastest growing component of workers’ compensation medical expenses, pharmacy costs make up between 10% and 15% of the total workers’ compensation bill – and utilization rates are only expected to rise. Workers’ compensation payors are faced with unique prescription benefit challenges such as off-label prescribing, inappropriate physician prescribing habits, and increased abuse of the system as more workers lose coverage under conventional insurance plans. These issues are amplified as the US workforce continues to age, and the risk of on-the-job injuries grows.

US Script understands the complexity of the workers’ compensation prescription benefit, and helps payors contain drug costs while providing needed benefits to injured workers. With state-of-the-art point-of-sale (POS) claims processing, enhanced clinical programs, and the experience and knowledge of US Script’s team of experts, we can design the benefit plan you require.

Nurtur™ Health Management[back to top]

US Script’s Nurtur™ health management program has been a leading innovator in best-in-class health management programs since 1997. Nurtur™ clients include health plans and nationally known employers—including many Fortune 500 companies—covering more than 7 million lives. Employer clients are from an array of industries, such as technology, finance, health systems, transportation, utilities, manufacturing, retail, unions and TPAs. Nurtur™ has full URAC disease management accreditation for the coronary artery disease (CAD), congestive heart failure (CHF) and diabetes programs and NCQA accreditation for the asthma and chronic obstructive pulmonary disease (COPD) programs.

Nurtur™ distinguishes itself from competitors in the richness of its participant-centered health management model. With the ability to integrate with other care managers, Nurtur™ provides optimal health management for each participant throughout the entire continuum of care. Its multi-disciplinary approach delivers real care and real results by always putting people first. The caring relationships the personal health coaches develop with their participants result in a lifetime of healthy behavioral change. The result is proven financial and clinical outcomes for employers and healthier, more productive lives at work and at home for program participants.

Coordination of Benefit Solutions with HD-RX[back to top]

US Script’s HD-RX program adds a layer of benefits to existing high deductible prescription plans that employers can use to bridge the gap in prescription coverage by self-insuring the deductible as a secondary benefit. Pharmacy claims are processed through the high deductible plan as the primary carrier and are then submitted to US Script as the secondary carrier.

The secondary benefit administered through the HD-RX program covers the plan member through the deductible period, and is flexible enough to support a variety of co-pay options including fixed and percentage co-pays. In short, the secondary coverage can be completely customized to meet the plan sponsor’s needs. Best of all, the HD-RX program is seamless to the plan member. When the member presents his/her prescription card(s) at the pharmacy, US Script’s HD-RX network pharmacies will process the claim according to US Script’s defined program logic, ensuring that the proper payor is charged for services and that accurate co-payment is collected at the pharmacy.

After serving County Healthcare programs for more than 15 years, US Script has built an expertise for designing pharmacy benefit plans that ease the administration and delivery of benefits to these unique patient populations. US Script’s prescription plan design options for County facilities include:

» Maximum prescriptions settings (e.g., limit three per month)

» Closed physician networks

» Maximum benefit amounts

» Closed pharmacy networks

» Quantity limits and age limits

» Custom formularies

In addition to these plan design elements, US Script works with County facilities and uses plan-specific claim information to create benefit plans that make sense for their patient populations and goals.

Today, behavioral health facilities are faced with the challenge of managing ever-escalating drug costs while providing effective pharmaceutical treatment to patients with mental illness, mental retardation and developmental disabilities. US Script caters to Mental Health Mental Retardation (MHMR) Centers and Behavioral Health Facilities by providing a unique array of services and products designed to meet your pharmaceutical management goals. We listen to your needs and work closely with you to maximize the value of prescription benefits while improving care and controlling costs.

The costs of more than 1,500 brand medications are covered by over 150 different pharmaceutical companies and programs. US Script is committed to providing access to free medications for those individuals most in need through the Patient Assistance Program (PAP) Management System. This program helps you conveniently access the medications your patients need through:

» Online Eligibility Information

» Web-based Application Tools

» PAP Medication Inventory and Storage

» Mail Order Medication Delivery

» Renewal Administration Services

» In-house Education and Training

US Script’s online tools provide clinic staff with access to eligibility requirements for most major free medication programs. Once staff determines that a patient is eligible for a program, a web-based application tool makes it easy to apply for medications on behalf of patients online.

After medications are ordered, US Script’s mail order facility, RxDirect, can store medications and ship them when needed free-of-charge. And when it comes time for a prescription renewal, US Script staff helps you through the renewal process.

Providers in today’s health benefits marketplace must find creative, realistic, affordable ways to offer a significant pharmacy benefit to their members. That's why US Script offers RX Advantage, a discount drug card solution that allows you to provide plan members with a benefit they can appreciate without amassing heavy overhead costs, transaction fees, and administrative workloads.

Using the RX Advantage program, both you and your membership can take advantage of our discounted, contracted pharmacy rates and hassle-free processing. When a member visits one of our more than 50,000 participating pharmacies, he has only to provide the pharmacist with a RX Advantage membership card to access exclusive drug discounts. The pharmacist processes the claim as he would any other insurance program, and the discounted cost of the prescription is charged either to a member-identified credit card account or to an account created solely for the RX Advantage program. Members are then billed monthly via credit card statement for their pharmaceutical expenses.

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Mission Statement
To be the best source of distinctive, clinically-driven pharmacy benefit management services with customized solutions and a comprehensive portfolio of programs designed to moderate healthcare pharmacy costs.

Vision
To be recognized as an industry leader in pharmacy benefit management, with a reputation for unsurpassed quality programs and services.