Setting up new benefit plans and managing changes has never been easier
Traditional PBM software was designed around the basic principle of processing claims electronically. As it turns out, your clients and their employees don’t speak “claims”. RxConstruct is a flexible, benefit design solution designed from the ground up to build, manage, and communicate benefit plan information in a language that downstream stakeholders can understand. RxConstruct is currently used by many of the top PBMs across the U.S. to manage benefit plans for more than 38 million lives.
Flexible Benefit Design
At the core of RxConstruct is a powerful and dynamic data model designed to change as your business does.
Whether you’re managing Commercial, Medicare Part D benefits or Workers Comp benefit plans, RxConstruct supports them all. If you need to create a single plan combining retail and mail or separate plans for retail vs mail, it’s all up to you. Have a specialty program? No problem, you can create a separate plan for specialty drugs too.
Speed up the process of setting up benefit plans by copying a similar benefit plan or selecting from a pre-configured benefit plan template. With RxConstruct, you can create as many plan templates as you’d like, and re-use them for similar configurations.
Workflow & Change Control
Every benefit plan has stakeholders that must be informed of any changes made to plan design and configuration. Internally, this includes those who are responsible for setting up the benefit plan as well as approving it. Whether creating a new benefit plan or changing an existing one, there is a process that needs to be followed. This process may vary from one client to the next, however you should still be able to manage all of your plans from a single system. This is where RxConstruct adds value.
Built right into the core of RxConstruct is a flexible workflow and change control engine that tracks the status of every change made to every benefit plan, as well as what changed, who made the change and when the change was made. The best part is once a benefit plan is approved and published live, a change request must be submitted before the plan can be changed. With our change control features, you can go back in time and access any plan at any time and see exactly how the plan was setup.
Managing pharmacy benefits is a complex process and often requires many people and departments to be involved. The user-centric dashboard in RxConstruct informs all parties when it’s their turn to get involved. When a user or department is required to participate, a benefit change request is automatically assigned to them and they are notified. Every new benefit plan and change request must go through the complete workflow process prior to going live. If at any point during the workflow process a mistake is found, the plan can be pushed back to any previous step in the process for correction, validation, and approval.
The user-centric dashboard provides users with a quick glance at the work assigned to them, ensuring nothing falls through the cracks. Users can quickly identify higher priority tasks to ensure you meet your client promised service level guarantees.
At Adaptive Software, we realize that most companies use multiple software applications to run their business. We also know from experience that most applications were built in a silo, and there are few — if any — integration points. Software integration projects are typically very expensive, time-consuming and often have a very low ROI.
RxConstruct was designed from the ground up to play nice with other systems no matter what language they are written in or what database they use. Most functions within RxConstruct can be triggered via the XML powered interface giving your business ultimate control over the application. RxConstruct can also be setup to notify other systems when certain events occur and provide any data necessary. RxConstruct is your source of truth.
Reporting & Analytics
Finally, a tool for upper management to get a real-time, top down view of whats going on in their organization. Our dynamic analytics engine allows managers to pivot, sort, and print reports to their heart’s desire
Every business activity, process, task, decision and transaction is monitored and measured. You now have the ability to create real-time reports based on key indicators of your choice without the need to employ a 3rd-party reporting solution. Say goodbye to time-consuming audits.