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Pharmacy Benefit Managers (PBMs) play a vital role in the administration of claims for insurance companies. The ever-increasing cost of prescription medications is a challenge that is difficult to tackle and a PBM will partner with the insurance company to help control claims costs. In challenging times such as this, it is vital to the
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Insurance companies administering claims are tasked with overcoming many obstacles and difficulties within automobile no-fault and workers’ compensation claims. When claimants sustain injuries and require the use of prescription medicines together with durable medical equipment, prosthetics and orthotics (DMEPOS) services, insurance companies and their adjusters and examiners are confronted with many additional challenges above and beyond the typical complexities associated with claims. If your insurance company hasn’t considered integrating medical and pharmacy benefits, you
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Many benefits managers exist within the realm of the insurance industry. With the multitude of benefits management options available to an insurance company, the question of who really benefits from this relationship arises. In the case of insurance companies administering claims involving claimant use of durable medical equipment (DME), a durable medical equipment benefits manager
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The continuously rising cost of prescription Average Wholesale Prices (AWP) has been a troubling trend that impacts insurance companies, especially those within the workers’ compensation sector. Some generic prescriptions more than doubled in price between 2013 and 2014, according to a study conducted through Elsevier. Insurance companies face not only these rising prescription costs but also must address the potential for
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Several changes within the federal government have been taking place this year and perhaps none are of more interest to Pharmacy Benefit Managers (PBMs) than the recent change to the Food and Drug Administration (FDA) Commissioner role. Scott Gottlieb, M.D., has been named the new FDA commissioner and has the opportunity to impact both PBMs and
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