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WellPoint Next Rx
Making benefits smarter.
WellPoint NextRx is a progressive pharmacy benefit manager (PBM) helping health plans, employer groups and third party administrators target the reduction of total health care costs and improve health outcomes. Pharmacy benefits present unique challenges: breakthrough medications, increased utilization, an aging population. In the face of so many dynamics, WellPoint NextRx has smart solutions.
Total package.
NextRx provides all of the standard PBM services that clients expect. This includes claims processing, clinical and disease management programs, retail network, mail and specialty pharmacy, customer service, and rebate management. With roots that date back to the 1980’s, NextRx has years of experience in providing these fundamental services.
NextRx will help lead the industry into a new direction. How? By providing the products clients need to make their clients and members happy, healthy and well informed. And by helping members get the medicines, treatments and information they deserve.
Those looking to get more from their pharmacy benefits program – in dollars and in health – turn to WellPoint NextRx. Effective pharmacy programs. Lower net costs. Results all around.
1-800-451-0433
www.wellpointrx.com
www.anthemprescription.com
WellPoint NextRx is a Service Mark of WellPoint, Inc. Services are provided by a WellPoint PBM (either Professional Claim Services Inc., doing business as WellPoint Pharmacy Management, or Anthem Prescription Management, LLC, as appropriate). WellPoint NextRx is a division of WellPoint, Inc.
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pharmacy benefit management packages employer beneficiary insurance mail order pharmacy work communication programs wellness initiative PBM claim processing online pharmacy plans pharmaceutical regimen review home delivery
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Emdeon
Emdeon - Solutions that Simplify the Business of Healthcare for Providers, Payers, and Channel Partners.
Emdeon provides revenue and payment cycle solutions that connect payers, providers and patients to integrate and automate key business and administrative functions throughout the patient encounter. Through the use of our comprehensive suite of products and services, our customers are able to:
- improve efficiency
- reduce costs
- increase cash flow
and more efficiently manage the complex revenue and payment cycle process.
Emdeon is a leading provider of prescription benefit administration solutions that enable managed care organizations, prescription benefit managers and other healthcare payers to improve claims processing efficiencies and better control prescription drug costs. Building on our decades of experience, we provide pharmacy claims adjudication, data warehousing and ancillary administrative services that enable our clients to improve claims processing efficiency, attain total financial transparency and better control, prescription drug costs. Our easy-to-use, Windows-based system streamlines implementation and maintenance of your Prescription Benefit Programs. And because an efficient Benefit Program requires more than just routine business intelligence, Emdeon SelectRx Insight offers you the timely, dynamic, and secure clinical and financial reporting that your business demands.
Emdeon provides the systems infrastructure as well the administrative support necessary to allow payers to effectively manage their prescription benefit program in-house. Emdeon’s award-winning, flexible claims processing system supports complex benefit designs, multiple networks, and client-owned contracts.
Just tell us what you need. Emdeon can tailor our services to provide as much assistance as your organization needs:
- Our core service is pharmacy claims adjudication and data reporting
- We can provide transparent call center support for member and pharmacy calls
- We encourage and assist our clients in negotiating their own Retail Pharmacy Networks and maintain a MAC list while we handle the network administration
- We encourage our clients to hold their own Drug Manufacturer Rebate Contracts while providing them with additional clinical support and the drug manufacturer contract management tool to reconcile rebates with the manufacturers.
Pharmacy Claims Adjudication - The state-of-the-art SelectRx system offers a cost-effective alternative to the task of operating and maintaining an in-house pharmacy claims adjudication system.
Includes:
- SelectRx Insight - Web-based, ad hoc reporting tool, SelectRx Insight, provides a clear window into the clinical and financial information pharmacy benefit managers must use on a daily basis.
Flexible, customizable add-ons
- Rebate Management - Provides a secure, web-based manufacturer rebate management system with exceptional decision support capabilities that calculates, invoices, and reconciles rebates electronically for all manufacturers
- Network Administration - Fully supports client-negotiated retail pharmacy network contracts, but also maintains our own nationwide network of participating NCPDP licensed pharmacies.
- Customer Service Call Centers - Tapping nearly 20 years of Pharmacy expertise, Emdeon offers health plans exceptional solutions for outsourcing pharmacy and member call support that can save money and provide transparent staff extensions.
To experience how simple managing your prescription business could be, contact an Emdeon professional today.
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Emdeon Healthcare Information Systems and Healthcare Software, Emdeon Healthcare Solutions and Medicare DDE and Medicare Secondary Billing, Emdeon Online Bill Presentment and Patient Access Management, Patient Benefits, Patient Eligibility, Patient Friendly Billing, Patient Receivables, Patient Registration, Payment Posting, Revenue Cycle Management, Secondary Claim Processing and Verify Patient Information by Emdeon
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PRAM
PRAM was originally founded in 1989 as an Underwriter and a Registered Administrator with corporate headquarters located in the City of Brea in Orange, California and today has offices in Chicago and throughout the US. PRAM provides Pharmacy Consulting, Underwriting and Employee Benefit services to local, regional and national accounts.
Pharmacy Consulting Services
- Pharmacy benefit design support, backed by one of the most sophisticated predictive modeling systems available that ensures clients will know what to expect in terms of trend and enable them to budget accordingly.
- Operations and technical support experienced in managing and administering online pharmacy plans.
- Full Risk and Profit sharing programs for clients seeking fully insured options
- Specialty Pharmacy and Bio Tech programs
- PBM comparison studies to provide clients with information on which PBM really has the lowest net cost.
- PBM Audits
Underwriting Services
The following lists the types of fully insured pharmacy carve-out plans that PRAM underwrites currently:
- Employer Groups
- Seniors - Retirees
- Generic Only Products for Limited Benefit Programs
- Insured Programs sold with Medicare Supplement Programs
- Association Programs
- State and Local Government Programs
- Pure Fronting arrangements
We believe our experience in all aspects of Risk Management Consulting, including the understanding of Pharmacy Risk with the support of Staff Pharmacists will add value in providing strategic planning in a growing complex industry. Our goals are to help our clients understand and manage issues relating to medical and pharmacy claim cost while providing leading edge technology to analyze options that will have a positive impact on rising trends while balancing the needs of appropriate therapy.
PRAM's Underwriting Staff and Pharmacy team brings years of experience in working with many of the nations leading insurance companies, national consultants, pharmacy benefit managers, and employer groups. This experience is passed on to our clients to facilitate the decision making process and provide solutions to complex issues.
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pharmacy benefit management packages employer beneficiary insurance mail order pharmacy work communication programs wellness initiative PBM claim processing online pharmacy plans pharmaceutical regimen review home delivery
Career Opportunities!
RXinsider’s Virtual Job EXPOs are the perfect online destination for healthcare practitioners seeking to research and connect with leading healthcare employers throughout every practice setting. Hundreds of healthcare employers, thousands of jobs, all in one convenient location!
RXinsider currently offers Virtual Job EXPOS for the following healthcare disciplines:
- Pharmacy
- Nursing
- HIT/HIM/Informatics
- Therapy/Allied
- Healthcare
Advertising Opportunities:
Attracting more than one million visitors annually, RXinsider’s Virtual Job EXPOs are an excellent venue for employers to post career opportunities, brand their organizations, and connect with healthcare professionals throughout multiple disciplines.
Our unique Job EXPO format allows employers to not only address acute needs, but develop a proactive strategy for future needs. Please contact an RXinsider Sales Representative for advertising information: http://rxinsider.com/advertise.htm
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Long term care pharmacy Nuclear / Radiopharmacy Long Term Care / LTC Clinical Hospital / Health System Home Infusion Temporary and Per-Diem Staffing Pharmacy Benefit Management / PBM Managed Care Telepharmacy Medical Science Liaison / MSL Specialty Pharmacy Management & Consulting Independent Community / Retail Chain Community / Retail Mail Order
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Medco
Medco is a leading pharmacy benefit manager (PBM) with the nation's largest mail order pharmacy operations. Medco assists its customers to moderate the cost and enhance the quality of prescription drug benefits provided to members nationwide. Ensuring that millions of Americans have access to affordable, high quality prescription healthcare is more than our business - it's our calling.
Every day, our employees dedicate themselves to bringing:
- Better Care
- Better Value
- Better Service
When your health plan or employer chooses Medco for prescription benefit coverage, you can be confident you're receiving the best care and service available. But we don't just safeguard the quality of your prescriptions. We work hard to provide you with information to help make informed decisions about the cost of your medications and available alternatives for you and your healthcare provider to consider. This includes information about savings that may be offered through our mail-order service or about the use of clinically-appropriate generic drugs.
And we are a company that never stops trying to do it better. At Medco, good has never been good enough. We've always been at the forefront of the industry - in knowledge, innovation, technology, and in pioneering new products and services. You can count on us to continue to be a catalyst for positive change because, at Medco, we never stop trying to do it better.
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pharmacy benefit management packages employer beneficiary insurance mail order pharmacy work communication programs wellness initiative PBM claim processing online pharmacy plans pharmaceutical regimen review home delivery
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CAREMARK
Caremark Inc. is one of the largest pharmaceutical services companies in the United States and one of the nation’s leading prescription benefits managers (PBM. More than 20 million plan participants each year receive over 90 million prescriptions through Caremark, and more than 1,200 plan sponsors—corporations, insurance companies, managed care organizations, government entities, and unions—rely on Caremark to design and fulfill their prescription drug benefit plans. |
Medco
Medco is a leading pharmacy benefit manager (PBM) with the nation's largest mail order pharmacy operations. Medco assists its customers to moderate the cost and enhance the quality of prescription drug benefits provided to members nationwide. Ensuring that millions of Americans have access to affordable, high quality prescription healthcare is more than our business - it's our calling. |
Pram Consulting
PRAM was originally founded in 1989 as an Underwriter and a Registered Administrator with corporate headquarters located in the City of Brea in Orange, California and today has offices in Chicago and throughout the US. PRAM provides Pharmacy Consulting, Underwriting and Employee Benefit services to local, regional and national accounts. |
ProAct Pharmacy Services
ProAct, Inc. is a full service pharmacy benefits management company based in New York State that has a primary focus on member service and education. ProAct’s target market is employer groups with 100 members or more. Each employer group using ProAct has a custom built prescription plan which has been specifically tailored to meet the group’s particular quality of care, financial and contractual goals.
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Rite Aid Health Solutions
Voted #1 pharmacy benefits manager in customer satisfaction in the 2006 WilsonRx® Pharmacy Benefit Satisfaction Survey*, Rite Aid Health Solutions brings a one-of-a-kind perspective to the table.
Backed by 44 years of pharmacy experience, we offer pharmacy benefits packages complete with quick-response customer service and support, along with professional clinical pharmacy consultation and management.
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WellPoint NextRx
WellPoint NextRx is a progressive pharmacy benefit manager (PBM) helping health plans, employer groups and third party administrators target the reduction of total health care costs and improve health outcomes. |
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Off Pump Coronary Artery Bypass: Positioning and Stabilization
Provided by: American Association for Thoracic Surgery
Off Pump Coronary Artery Bypass: Positioning and Stabilization CME
John D. Puskas, MD and Joseph F. Sabik III, MD
RELEASE DATE: July 7, 2006
LAST REVIEWED: July 2009
CME EXPIRATION: July 1, 2012
The American Association for Thoracic Surgery is accredited by the Accreditation Council for Cont... |
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Head Lice: An Update on Diagnosis & Treatment
Provided by: Power-Pak C.E.®
To provide pharmacists with an enhanced understanding of head lice infestation and current treatment modalities and strategies to educate, counsel, and monitor patients with head lice infestation.... |
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Hearing Loss Part 2
Provided by: CMElectures
Robert T. Sataloff, MD, is a professor of otolaryngology, head and neck surgery at Jefferson Medical College, and an adjunct professor of otorhinolaryngology at the University of Pennsylvania. Here, he discusses the anatomy and physiology of the outer ear, the middle ear, and the inner ear. The inner ear, he says, is divided into the vestibular lab... |
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Dental Infection Control - California, New York, Maryland, Minnesota & North Dakota Approved
Provided by: Biologix Solutions, LLC
Upon completion of this course, you will be able to learn:
Describe the impact of healthcare-associated infections in the dental setting.
Explain the responsibility of dental healthcare professionals to adhere to scientifically accepted principles and practices of infection control.
Define the concept of the chain of infection and present strate... |
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End-of-Life Care
Provided by: Wild Iris Medical Education
Upon completion of this course, you will be able to:
* Summarize the current status of end-of-life care in the United States.
* Explain the principles and ethical challenges of end-of-life care and hospice.
* Discuss the essential elements of effective communication with patient and family.
* List pharmacologic and nonpharmacologic comfort me... |
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Insights into Pain Management - Module 7: Multidisciplinary Pain Management
Provided by: University of Pennsylvania School of Medicine
Insights into Pain Management -
Module 7: Multidisciplinary Pain Management
Faculty: Michael A. Ashburn, MD, MPH, MBA (Chair)
Professor of Anesthesiology and Critical Care
Director, Pain Medicine and Palliative Care
University of Pennsylvania Health System
Philadelphia, Pennsylvania
Estimated Time to Complete: 1 hour
Credit: Up to 1 AM... |
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Evaluation and Treatment of Acute Arthritis
Provided by: CMEweb.com
**Objectives:**
* Summarize the most recent significant primary care medicine-related studies
* Discuss up-to-date information on all aspects of primary care, including new drugs, techniques, equipment, trials, studies, books, teaching aids, and other information pertinent to primary care
* Evaluate the credibility of published data and recom... |
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HIV/AIDS for Florida Healthcare Professionals (4 CH)
Provided by: Wild Iris Medical Education
Upon completion of this course, you will be able to:
* Discuss the causes of HIV/AIDS and its incidence in the United States and in Florida.
* List possible co-infections and explain their management.
* Name commonly used tests for HIV/AIDS.
* Describe modes of transmission for HIV.
* Explain the clinical management of HIV/AIDS.
* Outline t... |
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Anemia
Provided by: The Ohio State University Medical Center
Upon completion of this educational activity,the participant will be able to: 1.) Recognize how to classify anemias. 2.) Review the use of the CBC in the initial evaluation of anemia and subsequent appropriate lab tests.... |
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Focus On: The ED Management of Pediatric Apparent Life-Threatening Events
Provided by: American College of Emergency Physicians
After reading this article, the physician should be able to:
* Have a safe, measured, and consistent approach to the child with suspected apparent life threatening events (ALTE).
* Decide which investigations should be considered for patients presenting with ALTE.
* Identify as early as possible during an emergency department visit... |
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Pain Management -Acute
Provided by: CMElectures
Leslie Zun, MD, is professor of emergency medicine at Finch University/The Chicago Medical School, and chair of emergency medicine at Chicago's Mount Sinai Hospital. Here, he discusses acute pain management in the ER, where, he contends, there is inadequate dosing and underuse of pain medications. He explains several organizational guidelines such ... |
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Ductal Carcinoma in Situ of the Breast: MR Imaging Findings with Histopathologic Correlation
Provided by: Radiological Society of North America
Ductal Carcinoma in Situ of the Breast: MR Imaging Findings with Histopathologic Correlation... |
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Treatment Guidelines and Management of Patients with Type 2 Diabetes: Practical Strategies to Improve Glycemic Control (Module II of II)
Provided by: Horizon CME
ACTIVITY OVERVIEW
An on-line enduring CME program to educate physicians, nurses, and pharmacists on the current guidelines and strategies to improve glycemic control and close the clinical care gaps for the treatment of Type 2 diabetes. This will be a two-part learning series. Module I of the series will be lecture based, while Module II will be a... |
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Immunological and Inflammatory Aspects of Periodontal Disease
Provided by: Academy of General Dentistry
This continuing education course is designed for general dentists, dental hygienists, dental students and dental hygiene students. The course reviews key components of the immune system and their coordinated roles in preventing and eliminating the etiologic agents of disease. Current concepts in the immunopathogenesis of periodontal disease will be... |
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VISICU Critical Care Review -February 2010
Provided by: American Board of Quality Assurance And Utilization Review Physicians
Course Description & Objectives
* Review the issue of H1N1 influenza of severity requiring hospitalization
* Review the issue of the subset of hospitalized H1N1 influenza patients requiring ICU care.
* Review the characteristics of H1N1 patients requiring ICU care
* Review the care administered to H1N1 patients admitted to... |
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MRI of the Brain Supratentorial Neoplasia, Part II
Provided by: PROSCAN Imaging Education Foundation
The ProScan Imaging Education Foundation's all-new Professional MRI Series provides a comprehensive educational program that encompasses a broad survey of up-to-date radiological knowledge in the neurological and musculoskeletal realms. Lectures address in-depth discussions of neuroradiology of the brain, spine, head and neck, and pediatric imaging... |
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HIV/AIDS: A Primer for Pharmacists
Provided by: U.S. Pharmacist
This accredited activity is targeted to pharmacists and pharmacy technicians. Estimated time to complete this activity is 120 minutes.
GOAL:
To provide an overview of HIV and AIDS, including clinical features, diagnosis, and treatment strategies.
OBJECTIVES:
After completing this activity, the participant should be able to:
1. Explain th... |
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The Telephone in Clinical Medicine: An Instrument of Risk and Opportunity
Provided by: Harvard Medical School
Please note that this course also offers 3.6 nursing contact hours through the Department of Nursing Education, Harvard Medical School and Harvard Pilgrim Health Care. To obtain a CEU certificate, please make sure your registration form indicates your RN degree.
In addition, this course is designed to meet the requirement for 3 hours of Risk Man... |
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Assessing and Improving Value in Cancer Care -Emerging Policy Issues
Provided by: The Society for Translational Oncology
1. Describe the difficulty of assessing real-world value for insurers due to practice-to-practice variation in treatment approaches for cancer, and to explain three or more reasons evidence from clinical trials does not translate into standard treatment once an FDA-approved treatment reaches the community (the cascade of chaos).
2. Identify ... |
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Complications of Continuous Ambulatory Peritoneal Dialysis
Provided by: Radiological Society of North America
Learning Objectives: 1) Identify the causes of complications of CAPD. 2) Recognize the imaging features of complications of CAPD. 3)Describe the strengths and weaknesses of different imaging modalities for the diagnosis of CAPD complications.... |
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MRI of the Spine, Part V Lumbar Introduction to MRI Pathology Technique, Part B
Provided by: PROSCAN Imaging Education Foundation
The ProScan Imaging Education Foundation's all-new Professional MRI Series provides a comprehensive educational program that encompasses a broad survey of up-to-date radiological knowledge in the neurological and musculoskeletal realms. Lectures address in-depth discussions of neuroradiology of the brain, spine, head and neck, and pediatric imaging... |
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What You Always Wanted to Know About Childhood Lead Poisoning
Provided by: University of California, Davis, Health System
Pediatric Regularly Scheduled Series(RSS)
This free CME activity is on the new UC CME California web site.
Course consists of the following elements:
Create account on the CME California web site and register for the activity. Participation is accomplished through self-directed viewing of the web-based material. CME credit is obtained upon c... |
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Allergic Disease in Infants: Strategies for Prevention
Provided by: myCME.com
Allergic diseases in children, including atopic dermatitis and food allergies, have become dramatically more common in recent decades and have a negative effect on patients’ and parents’ quality of life. Allergies, which include atopic dermatitis, food allergies, allergic rhinitis, and asthma, are now the third most common chronic disease in ch... |
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MRI of Shoulder Instability, the Labrum, and Beyond
Provided by: PROSCAN Imaging Education Foundation
The ProScan Imaging Education Foundation's all-new Professional MRI Series provides a comprehensive educational program that encompasses a broad survey of up-to-date radiological knowledge in the neurological and musculoskeletal realms. Lectures address in-depth discussions of neuroradiology of the brain, spine, head and neck, and pediatric imaging... |
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Magnificent Seven -Part II Marrow/Edema and Acute Bone Injuries
Provided by: PROSCAN Imaging Education Foundation
The Master's Series features Dr. Stephen J. Pomeranz's most advanced lectures on diagnostic imaging to date. These intense and detailed presentations will focus on the topics of orthopaedic, neurologic, and body imaging. Each title in the series will examine subjects such as subtle interpretative techniques, anatomic detail, mastery of key technica... |
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Genetics: Myotonic Dystrophy
Provided by: Harvard Medical School
Acknowledgement: This course is supported by educational grants from Celera and the Applera Charitable Foundation.
There are several genetics diagnoses that can present with complete heart block. However, complete heart block in the context of a family history of muscle weakness and stiffness (myotonia) can be indicative of myotonic dystrophy. M... |
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Coding and Billing in Best Run Practices
Provided by: American Association of Professional Coders
Overview:
Learn how to easily implement proven steps to fortify coding, billing, collections and bottom line results. Turn everyday operations into a team-driven powerhouse that increases revenue, reduces back end claim hassles, and produces rock solid documentation.
In this workshop you will learn how to empower office staff to simultaneously ... |
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Childhood Depression & Anxiety
Provided by: CEU4U
**After completion of this course the participant should be able to:**
* To assist the reader in making a differential diagnosis of childhood mood disorders.
* To assist the reader in understanding the differing intervention strategies at the clinician's disposal for treating these issues.
* To encourage the reader to think broadly regarding chi... |
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Imaging Pelvic Floor Disorders: Trend Toward Comprehensive MRI
Provided by: American Roentgen Ray Society
Peer-reviewed articles from American Journal of Roentgenology (AJR). This activity offers AMA PRA Category 1 Credit(s)(TM) following completion of an online test.... |
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MRI of the Ankle and Foot Comprehensive Overview
Provided by: PROSCAN Imaging Education Foundation
The ProScan Imaging Education Foundation's all-new Professional MRI Series provides a comprehensive educational program that encompasses a broad survey of up-to-date radiological knowledge in the neurological and musculoskeletal realms. Lectures address in-depth discussions of neuroradiology of the brain, spine, head and neck, and pediatric imaging... |
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