Catamaran Helps Worker’s Compensation Clients Stay Well Ahead
The prescription component of workers’ compensation is a highly-regulated market that presents unique clinical, billing, network and communications challenges. Benefits differ from state to state and are further complicated by jurisdiction regulations and fee schedules—and many states now require increased reporting. Workers’ Compensation companies need an innovative partner to help them find ways to better manage today’s prescription costs and better plan for tomorrow’s healthcare needs. Your PBM must also have an understanding of the unique challenges of the industry, including increased potential for substance abuse, fraud, waste, quality of life programs and the potential safety issues that physician dispensing and third party billers perpetuate.
Catamaran’s Workers’ Compensation Solutions
As one of the few pharmacy benefit managers that provides a dedicated workers’ compensation team familiar with the nuances of the industry, Catamaran is able to customize our services to meet your unique requirements and priorities. We have experts who understand the compliance, regulatory and legal nuances of this state legislated arena. This not only gives us insight into the provider community and approaches to hot-button needs such as enhanced clinical intervention, fraud and abuse programs, risk mitigation and network penetration, but it also allows us an opportunity to develop innovative programs for our clients to assist in maximizing their in-house resources.
Safe and effective clinical services are important to support the claims adjuster to ensure medication therapy goals are achieved in support of the overall patient treatment plan. Enhanced clinical interventions, including retrospective DUR (RetroDUR) and concurrent DUR (C-DUR) programs provide complete utilization management designed to support pharmacy benefit and total healthcare cost containment. The programs accomplish these goals through interventions designed to promote proper prescribing in accordance with clinical literature and national guidelines. Catamaran RetroDUR and C-DUR helps patients avoid inappropriate or potentially dangerous medications. By helping to reduce the risk of adverse drug events and elevating the quality of care for patients, we reduce healthcare expenditures for worker’s compensation payers.
Our dedicated account team collaborates with clients to understand their goals and define the desired results. We then leverage our flexible technology platform to design and deliver the services and programs you need to enable your continued growth and success.
Why choose Catamaran? In an industry dominated by off-the-shelf solutions, only Catamaran delivers much needed flexibility, charting individualized courses that deliver the very best outcomes to keep our clients well ahead.