PharmaHelps

CARERx - Patient Access Copay Assistance Platform

A Division of Integrated Informatics

See more information about CARERx here.

PharmaHelps.org introduces RebateDirect, a new solution for providing rebates to hospitals.

Prescriptions Intake

  • Patient Enroll
  • Prescriber Integration
    • (Real Time Benefit Verification with Intent to Fill, Prior Auth, EMR* integration)

Process

  • Integrated Pharmacy Claims Processor
  • Real Time Data Driven Optimization with ML

Adherence

  • First Fill & Refills (Integrated with Prescription Orders
  • Compassionate Communications -- calls and SMS

Compliance

  • GPICS (Government Pharmacy Insurance Check System)
    • Real-time check on submitted insurance
  • Ongoing pharmacy claims real-time audit
    • OCC0, OCC3, and OCC8

System

  • Cost Effectiveness
    • (Fees based on claim volume and not the price of the drug)
  • Real Time Integration API with Manufacturer's System
  • Super cool and flexible reports and dashboards

Experience Matters, Find Out Why!

Our developers, engineers, managers, and executives have decades of expertise developing, deploying, and supporting pharmacy benefit management (PBM) claims software systems to serve the entire spectrum of the pharmacy benefit management industry. We are experts at developing and administering copay cards, rebates, vouchers, and patient assistance programs, all of which are designed to help patients afford medications. There are numerous ways to customize each program. Contact us to discover the impact we can make on your business.

What is the value proposition?
  • PharmaHelps is a vertically integrated system in the copay assistance program marketplace. We are a player in pharma market access.
  • PharmaHelps receives prescription orders as HUB, facilitates patient registration and fulfills prescriptions through partner pharmacies.
  • PharmaHelps has a built-in claims processor and allows for easily customizable plans. The System has a bulit-in claims processor with a capability to be compliant; compliance includes verifying that the insurance credentials are not government affiliated, that the final pricing after buy-down meets medicare best price guideline (U&C) and that the processed claims report is ready for audit.
  • PharmaHelps also provides a web based Real Time Pharmacy Benefit Solution.
  • Since PharmaHelps is fully integrated, PharmaHelps provides aggressive pricing, is responsive to custom changes (no need for multiple party integration) and makes what-if scenarios available.
Examples of Flexibility of Plans offered by PharmaHelps

A pharma company wanted to study the elasticity of the subsidy pricing (copay coupon values) by segmenting pharma networks offering different coupon values at different segments.
-- PharmaHelps helped the Company in segmentation and pricing.

A pharma company wanted to study the elasticity of the subsidy pricing by offering different coupon values for different fills (first fill and subsequent fills).
-- PharmaHelps helped the Company in defining the Plans and copay subsidies based on refills and refill intervals.

Examples of Flexibility of Costs (Fees) offered by PharmaHelps

A pharma company wanted PharmaHelps to charge different processing fees depending up on when the medication is dispensed to (a) cash paying patients, (b) to patients with insurance but the medication is not in the formulary of the insurance and (c) to patients with insurance and the medication is in the formulary. Further, the pharma company desired that the processing fees chargeable by PharmaHelps be on a sliding scale based on the amount paid by the insurance company.
-- PharmaHelps helped the Company in structuring the fees benefiting the Company and patients.

Adjudication Software
PharmaHelps is a fully customizable and brandable market access platform that can be tailored to any customer's individual needs. It is built on a PBM claims processing engine that can be set up with any plan specifications you provide. We provide you with the tools you need, such as real-time technology and data solutions, to help you streamline data aggregation and make it even easier for clinicians and patients to access. Instant access to reports, including the most recent payer policy and coverage statistics.
Network Services
PharmaHelps offers cost-effective network services for both broad-based and customized networks. You can use your own network or ours. Choose from a variety of programs and tailor your spending to your preferred and non-preferred networks.
Compliance
Compliance and risk mitigation solutions that safeguard your program from risk factors such as pharmacy fraud and government exclusion.
Copay and Patient Assistance Programs
A seamless patient experience that alleviates the patient's stress points and puts them at ease from the time the prescription is received until it is fulfilled at the pharmacy. Easy-to-implement patient access programs.
Benefit Verification Programs
We provide benefit verification programs to ensure payment for claims and minimize claim denials.
Getting the Most from Reimbursement
PharmaHelps works with all our partners to help stakeholders to understand such things as the market landscape and government policy to ensure that everyone gets the most from reimbursement.

Market Access Made Easier

  • Flexible

  • Cost effective

  • Responsible

We have our own claims processor.

We provide Plan Design.