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Commercial Pharmacy Benefit Solutions

Flexible pharmacy claims processing platform and efficient distribution channel management services for employers and third-party administrators who want to improve processes while controlling drug costs.

 

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5features to help control costs and improve pharmacy claims processing

Smart commercial pharmacy services

Gain flexibility and efficiency

We manage your pharmacy benefits utilizing an easy-to-use, cloud-based system that supports complex benefit designs and multiple distribution channel networks.

Smart commercial pharmacy services

Adjudicate pharmacy claims

Our NCPDP-compliant platform is designed to manage and process claims in real time.

Smart commercial pharmacy services

Consultative analytics

Leverage customized analytics and identify trends and opportunities to help improve the cost effectiveness of your pharmacy programs.

Smart commercial pharmacy services

Pharmacy cost containment

Access our variety of services and support options to keep you on the leading edge of pharmacy claims processing and benefit management.

Smart commercial pharmacy services

Member-centric model

Member-focused service model with a call center that quickly connects members to a live person committed to first-call resolution.

What’s included in Commercial Pharmacy Benefit Solutions

  • Strategic collaboration

    • Change Healthcare has been assisting clients with pharmacy benefit management needs for more than 40 years.
    • We provide thorough training, leveraging our expertise to help improve our customers’ pharmacy claims adjudication and overall pharmacy cost position.
    • We support our customers by maintaining member eligibility data, formularies, and other data that can be exchanged in predetermined formats and frequencies. 

  • Client-customized programs

    • Our proprietary systems are feature-rich, highly configurable, and can support your programs as necessary.
    • Change Healthcare’s client roster includes pharmacy benefit managers (PBMs), third-party administrators, managed care plans, discount Rx drug card providers, and manufacturer coupon and voucher programs.
    • Administrative and technical support is always available for pharmacy and customer service call centers.

  • Consultative analytics

    • Customized pharmacy benefit management solutions that address your business needs.
    • Identify patient and utilization trends and other opportunities to improve your plan’s cost effectiveness and efficiency.
    • Comprehensive, on-demand reporting enables continuous performance measurement.

Our outcomes

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Article

Enabling Pharmacy Claims Processing in the Cloud

Article

Enabling Pharmacy Claims Processing in the Cloud

Learn why the cloud is the best solution for helping ensure the security, reliability, and speed of processing your organization’s pharmacy claims.

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Article

How a Pharmacy Benefit Manager Can Help Build Relationships

Article

How a Pharmacy Benefit Manager Can Help Build Relationships

In our world of frequent advancements in medicine and complex pricing in healthcare, patients and pharmacy benefit plan members need all the expertise they can get. Learn where to find it.

Learn More

Article

URAC Accreditation in Pharmacy Benefit Management

Article

URAC Accreditation in Pharmacy Benefit Management

Pharmacy benefit management (PBM) services are key to improving member experience and financial outcomes. Change Healthcare has earned URAC accreditation in PBM.

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Our experts will:

  • Discuss your individual use case and business needs
  • Explain our features, benefits, and services
  • Show how this solution can help achieve your goals

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Thank You

We appreciate your interest in Change Healthcare. A member of our team will contact you to better understand your needs and discuss potential solutions.

Together, we are accelerating the journey toward improved lives and healthier communities.