PharmUcare Services

Our dedicated focus is solely on the workers' compensation industry. As a result, we thoroughly understand the differences between workers' compensation and group health administration, and we provide the best solutions for workers' compensation-specific challenges.

We have more than 62,000 pharmacies nationwide. This includes all major pharmacy chains, as well as 9 out of 10 regional and independent pharmacies. The size and strength of our network provides injured workers with quick, convenient access to needed medication, ensuring that a participating pharmacy is always close to home or work.

We offer programs to ensure that pharmacies dispense the initial prescription of appropriate medications to your injured workers, while eliminating the risk and uncertainty retail pharmacies can experience in processing workers' compensation prescriptions. These proactive programs help to reduce the incidence of first fill claims "slipping" to third-party billers for reimbursement; therefore, eliminating premium charges at state fee schedule, saving you up to 30% in pharmacy spend.

Our Mail Order Pharmacy solution offers to meet the challenges of high-cost medication therapies for chronically injured workers. The pharmacy's scalable system architecture allows quick response to fulfillment requests, while passing a savings up to 35% over retail cost.

At PharmUcare, we custom design each prescription drug plan in accordance with the desires of the client. First, we come in a analyze your current program and processes, listening to feedback as to what is working for you and what areas need improvement. After discovering your goals and objectives, we design a plan to further improve your pharmacy services and reduce your overall cost. We also layout all the options and capabilities of a plan, allowing you to make an informative decision based on your unique needs.

Clinical pharmacists have developed and maintained all our workers' compensation-specific formularies. During our clinical review process coupled with our integrated technology, we can also narrow and design formularies at clinical-specific, injury-specific or individual levels. This helps ensure that medications are only dispensed for the specific injury of the injured worker.

Our technology provides point-of-sale Drug Utilization Review (DUR) services. The DUR platform instantly evaluates each prescription against a series of program edits prior to dispensing, ensuring that the medication is appropriate for the injury and related to the compensable injuries, which keeps medication costs from spiraling out of control and helps avoid fraud and abuse situations. The DUR platform helps identify:

Based on alerts in our DUR process, our professional pharmacists intervene with prescribing physicians and dispensing pharmacies on cases that require special clinical attention. Our clinical team is also available to provide drug information support to all prescribers, professional staff and injured workers to assist in the recovery process.

PharmUcare makes management of your pharmacy billing simple and convenient online. In addition, utilizing the Pharmacy Bill Review program allows us to review your paper bills and reduce them to Fee Schedule or U&C rates, then convert them to PUC's contracted rates for future dispensing of medications. Other benefits of the program include:

PharmUcare's online technology allows pharmacies to process the claim online in real-time to get prescriptions processed quickly and with no out of pocket expenses to the injured worker. In addition, our scalable technology can be integrated directly into your adjudication platform for seamless synchronization. There is also a web-based client portal, allowing you access to the following capabilities:

Our proprietary ClaimTrac™ web portal provides full reporting capabilities to our clients allowing you to make informative decisions based on analysis of real time information. If there is information you wish to analyze outside our standard suite of reports, we also have the flexibility and desire to customize reports to meet your specific needs.

In addition to real time reporting, your Account Manager will provide quarterly or bi-annual meetings to review results, evaluate program goals and objectives, discuss strategic initiatives, and identify potential adjustments to the plan and/or services to ensure your goals are continuously met and exceeded.

From day one, customers will be assigned a designated Customer Care Specialist to provide stability, accountability and outstanding individualized, end-to-end customer service to help you get the most from your partnership with us. You will have access to a dedicated toll free line connecting you with your designated Customer Care Specialist. For after hours support you will be connected with a full staff of dedicated professionals able to assist our clients, pharmacies and injured workers with their needs; therefore providing you with 24/7 customer support 365 days a year.

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PharmUcare Services
About PharmUCare
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