Pharmacy Benefit Management
Taking proper care of employees & pharmacy bills.
Minimizing patient risk and reducing pharmacy spend go hand-in-hand with solutions that ensure prescriptions are optimized to help injured workers recover and employers avoid unnecessary costs.
Our Approach
- Minimize pharmacy spendOptimize your savings through several avenues with CorVel’s pharmacy benefit management (PBM) program which includes opioid management, enforced generic dispensing, and conversion of high-cost topical medications to cost-effective equivalents.
- Ensure appropriate medication for patientsCreate a safe path to recovery for injured workers. Our in-house pharmacists work side by side with nationally certified pharmacy technicians (CPhT) to confirm prescriptions are appropriate for an injured employee’s condition and the most cost-effective option too.
- Provide visibility into pharmacy dataMinimize untracked bills to manage risk throughout the claims process. We review bills through CareMC Edge to help you better track penetration across your pharmacy spend.
A range of services to optimize your pharmacy spend.
Prospective Management
Reduce out-of-network bills, paper bills, and third-party bills that are more difficult to manage. Our system filters them back into our PBM program for fast resolution.
Drug Utilization Review
Ensure injured workers are getting the most appropriate and cost-effective medications with support from pharmacists who provide expert reviews.
Clinical Modeling
Get insights into best treatments for employees with medication reviews that flag important information, including narcotics usage and drug history.
Brand-to-Generic Prescriptions
Reduce your overall pharmacy costs with our generic model, which substitutes higher-cost brand drugs with the more cost-effective generic equivalent.
Opioid Management
Address chronic pain with alternative solutions, including patient advocacy and physical therapy, which helps reduce reliance on opioids.
State Formulary and Plan Compliance
Ensure pharmacy formulations comply with state requirements and enforce limitations for states with limited oversight.
Ensuring resources well spent on pharmacy needs.
$0K
Savings per workers’ comp claim
0%
Reduction in pharmacy spend
0%
Reduction in opioid day supply
CareMC Edge
One platform to manage your entire claims process.
With CareMC Edge, the only fully integrated claims system in the industry, claims management will never be the same. CareMC Edge leverages best-in-class technology to provide greater transparency, help employees recover more quickly, and reduce losses.
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Our team is ready to answer any questions and help you find the right solutions.