Traditionally PBMs communicate prescribing and utilization patterns with physicians after the event leading health plans to profile physicians unfairly. Imagine how easy and productive it will be if physicians receive real time comprehensive patient specific (Patient-Rx360°) and actionable drug utilization review (IntelligentDUR360°Gateway™) pushed directly into your e-prescription/EMR workflow at the time of e-prescription or authorization request. Such a revolutionary approach is delivered through Collaborative PBM Cloud™ and its IntelligentDUR360°Gateway™, which has never been offered by any other PBM due to antiquated, fragmented, and legacy systems.
IntelligentDUR360°Gateway™ extracts information from multiple components of Collaborative PBM Cloud™, analyzes, packages, and delivers actionable information into physician’s workflow as a single message in less than 2 seconds as part of the benefit/formulary response (NCPDP SCRIPT 10.6). IntelligentDUR360°Gateway™ will also alert if the patient is MTM eligible enabling a physician driven CMR. IntelligentDUR 360°Gateway™ also communicates bonus compensation for completing the CMR. The fully automated CMR is completed in less than 15 minutes with full resolutions and queues up the payment in real-time from the PBM. Such a CMR can substantially improve overall patient quality of life and reduce avoidable medical and pharmacy costs ultimately leading to higher physician quality ratings. Physician will also be alerted with various pay-for-performance triggers, such as brand vs. generics, prescription planning, and coverage gap avoidance to improve adherence and reduce overall pharmacy costs at the point of care.