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rx_solutions

Industry: Pharmaceuticals & Life Sciences

 

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To discuss how our team can help your organization or to view a live presentation email us at research@systechusa.com

  Customer Quote

“We looked at a number of solutions providers. When we drilled into qualifications and verified references, it became obvious that Systech’s people were best qualified for the job.”

-Eric Bala, DSS Project Manager, Prescription Solutions

Prescription Solutions - Prescription Claims Analysis and Reporting

Background

Prescription Solutions began in early 1993 with a mission to provide comprehensive pharmacy benefit management programs and services to employer groups and managed care organizations. The programs and services offered are built upon Prescription Solutions expertise in providing managed pharmacy benefits to managed care organizations. Today Prescription Solutions provides pharmacy benefit management services to almost 5 million individuals nationwide.

Challenges

Prescription Solutions needed a powerful Business Intelligence system to cut costs and analyze their spending patterns across the country. An improvement in physician compliance to utilize and better manage the pharmacy dollar was needed. In order to lower healthcare costs and provide better services for customers they needed to find a cost effective, complete and comprehensive solution which would perform complex analysis quickly and efficiently.

Prescription Solutions did not have a way of analyzing claim costs, profits, sales comparisons, product comparisons and overall productivity analysis.Prescription Solutions wanted a robust system that would be easy for their IT department to maintain after it was implemented and also, one that would be scalable and reliable.

Solution

As a strategic consultant Systech's first responsibility was to evaluate Prescription Solution's current infrastructure and environment, and then recommended a database infrastructure for implementing the solution. Systech was responsible for building and maintaining a robust Business Intelligence solution. The data warehouse is used to report on a variety of information for a multitude of clients. This helps to identify top prescribers, members, and drugs by medical groups among many other functions. The data warehouse enabled the decision support system to perform accurate forecasts of the industry's leading trends, utilization trends & patterns and enhance overall information gathered.

Result

Prescription Solutions will be able to perform more accurate forecasts of pharmacy trends leading to improvements in benefit designs and pricing, resulting in better financial decisions. Physicians will be better informed and therefore provide quality health care for their patients. Fraudulent claim detection will help save the company millions of dollars.