Payer Insights Suite

Complete pharmacy benefit plan design and management

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Your single source of truth for formulary management

Maintaining control over processes related to pharmacy benefit plans and formulary management can be difficult.

Our payer insights suite enables users to gain control over their formulary data and member facing materials, easily set up pharmacy benefit plans and more with a single source of truth.

As a result, our clients rely on our applications to record formulary tiering and utilization management decisions, create criteria, keep pharmacy plans organized, and manage network contracts.

Consolidate and simplify

  1. Efficiency, consistency and control
    Centralize all formulary management activities in one place
  2. Automate and streamline your processes
    The payer insights suite eliminates processes that are error prone, such as manual data entry, and using disparate management tools.
  3. Ensure complete data consistency
    Leverage the only formulary management provider that directly integrates with claims adjudication systems.

End-to-end pharmacy benefit plan design and management

RxFlex

Take the complexity out of the designing, building, and on-going management of drug lists, formularies, criteria, and published materials, all while fostering control, promoting operating cost optimization, and aiding compliance.

  • Create and maintain formularies and utilization management edits manually or leverage RxFlex’s powerful auto-rules engine.
  • Leverage the only formulary management provider able to ensure complete data consistency through direct integration with claims adjudication systems.
  • Customize and generate marketing documents, and effectively communicate benefits to members.

RxDesigner

Create, design, and publish formulary PDFs and electronic web searches

  • Control branding by creating and publishing custom formulary PDFs (508 Compliant)
  • Easily upload HPMS formulary files
  • Customize branding for member drug search (WCAG 2.0 compliant)
  • Upload your own front and back content to each formulary
  • Publish all content to members

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