Problem
A regional workers' comp carrier had strategies planned with their PBM that the PBM could not operationalize. This locally grown PBM had a long partnership with the client, but they weren't producing the results they wanted. Enlyte later acquired the PBM, which allowed the client to get those solutions in place.
Solution
The success of the ScriptAdvisor solution sparked the client's interest in exploring Enlyte’s bill review program. An integrated program ensures there is 100% clinical oversight on all pharmacy transactions. Consolidating the program made sure each bill is filtered the same way through a consistent process.
Outcome
The integrated program resulted in increased year-over-year savings—17% increase in pharmacy savings and 9% increase in bill review savings.
17% increase in pharmacy savings
9% increase in bill review savings
Having the bill review and the ScriptAdvisor programs integrated gives enormous ease of use.
—VP Claim Operations, Regional Workers' Comp Carrier