Complete Pharmacy Solution

Every case has a different situation. Your staff may not have the solution, but generally knows what your company needs as an end result. SCS offers the due diligence necessary to understand first, then apply our knowledge and experience to solve your problems.

3 Phases to Success

Our system is unique but simple; we find the issues that are wrong, correct the mistakes and then monitor to insure success. We think of the process as a complete and continuous circle of control.

Audit

Stephens Consulting Services (SCS) utilizes proprietary PBM audit software that is second to none. We inspect every aspect of the processing procedure on 100% of your pharmacy claims data. Our software is designed to mimic a correct PBM processing, starting with the standard AWP source of either Medispan or First DataBank. With an input of the details of your benefit design, the audit software will highlight any and all discrepancies and calculate the overcharged amounts.

Changes

With the audit results, we work with you and your PBM to correct both the processing errors and needed changes to your benefit design. Often there are hidden issues that can only be revealed by the audit. SCS has developed Script Probe® - a set of reports that will show potential weaknesses in PBM processing and possible changes that will help reduce the pharmacy expense.

An obvious cost-reducing change would be to negotiate better contract terms. Because we are auditors and have past provider and PBM management experience, SCS can help you negotiate the best possible contract.

If the issues are not satisfactorily corrected by your PBM and your decision is to change your PBM relationship, SCS has the knowledge and experience to guide you through the PBM selection process. Our RFP procedure is unique due to our previous PBM management and auditing experience. We do not depend on “spreadsheet analysis” but will inspect each PBM candidate on how they process claims and edit benefit rules. The selection decision is yours, but you will have a better understanding of how each PBM makes profit and which one would have the best service and financial outcome.

Monitoring

With the current PBM status corrected and all benefit changes in place, the next step of our process is to monitor compliance- to “inspect what we expect”. SCS will work with you and the PBM to gather monthly pharmacy data for review. Quarterly audits and monthly data checks will insure correct pricing and drug coverage processing are accomplished. We will also monitor expected results with our Script Probe® reporting.

Control

The result of our 3 Phase Process is complete knowledge of your pharmacy benefit and a feeling of control of the pharmacy expense.