Pharmacy Benefit Management Services (PBM)

pharmacy benefit management

ProCare Rx is a national PBM celebrating 25 years of experience in the healthcare industry. No matter the size or complexity of your company, we can tailor our knowledge to your needs.   In fact, we pioneered the business doctrine of transparency and are a leading advocate of full disclosure and superior reporting in the PBM industry. It is our mission to treat our clients with integrity and the highest level of customer service.

Each client works with their own ProCare Rx support team which delivers individual solutions and service for healthcare cost containment and member wellness. We have many options readily available: flexible copays, a national retail pharmacy network, pharmacy benefit designs to include HSA and HRA plans and clinical programs, as well as a mail order and specialty pharmacy and ProCare HospiceCare, a division offering palliative care medication therapy management for those with more complex medical conditions.

ProCare Rx Advantage

ProCare Rx has a strong information technology infrastructure and a proven track record for innovation and automation that includes:

  • 100% In-house Pharmacy Benefit IT Systems and Platforms
  • Exceptional Analytics and Reporting Capabilities
  • Internet-based Pharmacy Transaction Switching

Comprehensive Clinical Savings Programs

Understanding and implementing an appropriate cost-sharing strategy is the key to controlling your drug spend. The copay structure of your prescription benefit plan is the cornerstone of the many cost management programs to be considered. With ProCare Rx, you will save with the following programs:

  • Lowest Cost Formulary
  • Prior Authorization of High Cost Specialty Medications
  • Step Therapy and Quantity Limits
  • Therapeutic Interchange
  • Generic Drug Initiatives
  • OTC Switch Programs

We take great pride in the overall performance of our clinically driven and financially proven formulary and our "lowest net cost of therapy" philosophy. Clients using our formulary have maintained cost trends below inflation for the last five years.

National Pharmacy Network

Our national network of retail pharmacies and mail order service ensures that our clients' plan participants receive their medications in a convenient and cost-effective manner. ProCare Rx's national network includes 65,000+ major chain as well as independent pharmacies.

Superior Customer Service

Our dedicated team of pharmacists, pharmacy technicians, clinical personnel, technical staff and business personnel ensures that our clients receive the highest level of service. With millions of claims processed every year, we leverage our expertise to ensure that our clients achieve their business objectives.

ProCare Rx's Customer Care Center is available to our members, physicians and pharmacies 24 hours a day, every day of the year. Our highly trained staff is well equipped to communicate with all members, including the visually and hearing impaired as well as non-native English speakers.

Member Web Portal

ProCare Rx's member portal was developed with our customers in mind. Members can use this valuable resource to:

  • Look up member and dependent eligibility status
  • Find plan benefit information (copays, drug formulary, etc.)
  • Search for generic alternatives to brand drugs
  • Transfer maintenance or specialty pharmacy prescriptions from a retail pharmacy to ProCare PharmacyCare
  • Renew a prescription or review the order status of a mail service prescription filled at ProCare PharmacyCare
  • Order vitamins or other OTC products from ProCare PharmacyCare
  • Review prescription claims history or individual prescriptions
  • Price a prescription before taking it to one of our 65,000 pharmacies
  • Locate pharmacies within a zip code or radius

What Clients Are Saying About Us

ProCare Rx provides flexible and dynamic systems . . .
"The ProCare Rx system provides tremendous flexibility in benefit design, in addition to protocol and step therapy initiatives. This allows us to focus our efforts on inappropriate utilization with minimal impact on members, pharmacies, and physicians who are following the protocols. The real-time reporting capability allows us to quickly monitor trends, identify issues, and adjust interventions as needed."
Provider Relations, Large Healthcare Provider
ProCare Rx provides high quality customer service . . .
"We are very pleased with the supportive, professional staff at ProCare Rx. They understand the complexities of pharmacy benefits and transactions, the day-to-day operations of a pharmacy, and the types of problems to anticipate."
Provider Relations, Large Healthcare Provider

 

ProCare Rx is a national PBM company with over 20 years of experience in the healthcare industry. Whether your company is large or small, we tailor our knowledge to your needs. In fact, we pioneered the business doctrine of ‘transparency’

Innovation, Information, Reliability and Integrity, Procare Rx Is Ready To Serve The Distinctive Needs Of Your Company.

Experience

Our dedicated staff of pharmacists, pharmacy technicians, clinical personnel, technical and business personnel ensure that our clients receive the highest level of service. With millions of claims processed every year, we leverage proprietary processes with the right task, every time, to help you achieve your business objectives.

Personal Service

With the best staff of pharmacists and computer information systems specialists, project managers, benefit consultants, client service and operational support personnel, ProCare Rx is able to meet our clients' business needs in a timely and cost effective manner.

Service with Confidence

We don't just make promises to help manage clients' prescription drug benefit program. We stand by our services and products.