Enhancing Customer Experience Through Real Time Accumulator
Agile Health Technologies has worked extensively for various BCBS organizations. Our most recent success includes implementation of Prime Therapeutics at Blue Cross Blue Shield of Rhode Island
PBM in Healthcare – In order to stay competitive and offer the best possible experience to its members, every health plan chooses a PBM that meets their business objectives and consumer needs. Objectives such as discount and benefits, generic fill rate and transition to generics, speciality pharmacy, adaptive pricing, etc. are deciding factors in choosing the right PBM. A change in PBM also brings in business process changes and systems changes. At Agile Health Technologies Inc., we provide not only system integration and business solutions for PBM migration in Healthcare, but also continue to work with you to ensure the business objectives of the PBM migration are realized, benchmarked and socialized.
PBM in Healthcare – Agile Experience
Agile Health Technologies and its professionals have successfully completed PBM migrations such as migrating from WellPoint (now Express Script) to CVS Caremark, CVS Caremark to Catamaran/Optum Rx, and Optum Rx to Prime. We are experienced in both traditional batch integration and cutting edge, real time transactions.
Our Best Practices
Rules Engine: Agile technical framework defines the rules engine as the hub for all interfaces and transactional data. This becomes the central repository of all business rules such as a hybrid or aggregate plan for accumulator, carry over, or any plan specific business rules, etc.
Reference Architecture: An established reference architecture allows reusability of existing interfaces and extracts, establishing control and balance in every step. Performance, scalability, maintenance and operability are important criteria in the reference architecture.
Partner Engagement: The success of PBM implementation is dependent on effective partner engagement. Agile framework defines comprehensive and wise engagement at each phase to ensure all business objectives, requirements, joint testing and implementation/go live plans are met.