Why Use a PBM?

Why Use a Pharmacy Benefits Manager?

Pharmacy benefits managers (PBMs) in the workers’ compensation industry provide many advantages, not only to the injured workers, but to all other parties involved in their care. Below is a summary (not all-inclusive) of the valuable services that KeyScripts offers our customers.

Cost Containment

o   One of the main reasons why customers use KeyScripts is the cost containment programs implemented by KeyScripts that provide significant savings in multiple ways.

  • Access to a national pharmacy network with approximately 65,000 pharmacies such as CVS, Walgreens, Rite Aid, Target, and Wal-Mart to name a few, as well as independent neighborhood pharmacies throughout the country that offer discounts when the KeyScripts card is used.
  • Formulary development and maintenance specific to workers’ compensation injuries and claims. KeyScripts’ management has over 35 years of experience in the workers’ compensation field to ensure compensable medications are processed swiftly, inhibit non-compensable medications from being dispensed, and prevent drugs from processing through third party billers.
  • Prescription mail order option for chronic medications available at a decreased cost.

Expedited processing and delivery of medications

o   Electronic claim submission eliminates out-of-pocket costs for the injured worker and allows for prompt dispensing of required medications at a local pharmacy in the injured workers’ neighborhood.

Access to clinical programs and pharmacy professionals

o   Creation and maintenance of clinical programs (fraud, waste and abuse mitigation, opioid surveillance, specialty pharmacy utilization, compound medication supervision, clinical guideline recommendations etc.) designed to control appropriate utilization, promote safety, monitor efficacy and reduce costs of the injured workers’ pharmacy regimen and get them back to work quickly.

o   Pharmacists are the drug experts and are well-positioned to assist providers, prescribers and claims adjusters in appropriate medication utilization determination.

KeyScripts exclusive benefits

o   KeyScripts offers Durable Medical Equipment, Physical Medicine, Diagnostic Testing, Home Health, Transportation, Translation, Clinical Pharmacy Reviews, Lab Testing and a dashboard where you can go to see all of these services in one place which allows for greater savings without sacrificing outstanding customer service.

Are you underutilizing your PBM? To find out more on how you can leverage the full potential of your PBM reach out to your account representative or to one of our pharmacists.