by Dennis M. Sponer, CEO, ScripNet
These are exciting times at ScripNet as we have touched a number of state-of-the-art claims management capabilities and new services to better support our clients. Although we have always been proactive with technology, including the development of our point-of-sale (POS) pharmacy network, our Oracle-based ScripStar® Claims Management Database, our 24/7 professionally staffed live Help Desk and toll-free telephone and email network, we have launched a number of new services over the past months. These investments are designed to make it easier for us to manage our clients’ pharmacy benefit programs, contain costs, expand our service offerings and provide better customer service. Here’s a brief description of some of our latest offerings:
The ScripNet Access Point (SNAP) provides our clients with secure online access to their workers’ compensation claims data. The web portal enables analysts and adjusters to search by a number of different claims parameters and generate custom and periodic reports to more closely monitor and manage their business. Previously, client adjusters would reply to ScripNet’s Help Desk emails regarding pending authorizations (non-formulary claims that require prior authorization) with an approval or denial of the claim, specific drugs, number of refills, etc.
With SNAP, claims adjusters are able to see those pending authorizations online in real-time and have the option to make an immediate determination and online notation themselves.
Drug Utilization Reviews & Physician Outreach — ScripNet develops formularies for each of its clients, which are available to network pharmacists before dispensing a medication. Other real-time information that is available to pharmacists include: alerts for duplication of therapy, appropriate time intervals for refills and possible interactions. In addition to these Prospective and Concurrent Drug Utilization safeguards, ScripNet’s clinical pharmacist also conducts Retrospective Drug and Concurrent Drug Utilization Reviews with physician outreach, if it is requested by clients.
ScripNet recently conducted a DUR and physician outreach for Texas Property & Casualty Insurance Guarantee (TPCIGA), resulting in a reduced pharmacy spend of 48%, in addition to improving the health outcomes of patients addressed by the program. ScripNet’s DUR utilizes a proprietary statistical algorithm that identifies patients and claims that demonstrate the greatest potential for risk or abuse. DURs are a compliment to Work Loss Data Institute’s Official Disability Guidelines (ODG) – Treatment in Workers’ Compensation, which many states have adopted. Drug Utilization Reviews, combined with ODG compliance, will increase business process efficiencies and lower costs for the insured and insurance carriers, while improving safety and service for the injured worker.
Compounding — ScripNet announced the selection of ReCept Pharmacy as its preferred provider for dispensing compounded medications in Texas.
ReCept Pharmacy has a history of quality compounding including independent laboratory testing and verification of their compounding facilities. Injured workers will benefit from the highest levels of consistency, quality, and timeliness in receiving their medication because of ReCept’s specialization and expertise. This preferred provider relationship enables ScripNet to deliver compounded medications at very competitive prices.