Management
Reporting
The SCS staff members are experts in dealing with large data files.
Knowing what to look for and how to display results are key to any
data analysis. We can present reports that are non-standard to the
PBM industry.
Stephens Consulting Services has developed Script Probe® reporting-
a set of unique reports generated out of our audit software tool.
Although the report generator can produce any “ad-hoc”
report desired, SCS has designed reports that offer the client insights
to the Plan’s financial results, the PBM processing procedures,
Plan Design effectiveness, Member Utilization and potential design
changes to produce savings.
Our Script Probe® reports will help manage the pharmacy expense
and answer questions your PBM has not covered:
- Key Statistics Report - similar to
the financial report you get from the PBM but also includes the
MAC division for generics. The report also reveals AWP % discounts
for all categories, not typically seen on PBM reporting. One page,
total financial view.
- Trend Summary Report - uses past two
years of data to show trends in all categories of the Key Stat
Report but as trend percentages of current month against the same
month last year and also the year-to-date comparison to last year.
- MAC Detail and Survey - provides financial
results for roughly 40% of your drug utilization that is not detailed
by the PBM.
- Prior Authorization Report - shows
the PBM actions on payments due to approvals made by the PBM.
- Duplicate Therapy Report - this report
details claim activity listed by Member where the PBM has allowed
similar or exact drug coverage for a member with overlapping dates
of service.
- Potential Abuse Report - similar to
Duplicate Therapy but detailed for abuse potential drug use.
- Formulary Switch Report - PBMs typically
share only a portion of rebate. All PBMs desire a copay differential
and employ member and physician communication to push the drug
utilization to their formulary. The report utilizes an input of
the Previous Formulary to the Current Formulary List and examines
movement (“switches”) in brand utilization. Results
of the report are shown as the financial impacts of changing drugs
on both Member Copay and Ingredient Cost, giving a clear picture
of drug changes to the new formulary.
- Member Compliance Report - reviews
the data to detail the Member’s drug compliance on standard
Maintenance Medications.
- Specialty Drug Opportunity Report -
if allowed an open selection of pharmacies on specialty drugs,
this report shows the financial impact of Retail to Specialty
Pharmacy selection.
- Deductible Report - inspects the PBM’s
processing concerning Member deductible collection versus the
design limits.
- Quantity Limits Report - this is part
of our audit procedure. This report inspects the drugs that are
limited to quantity and time until possible next fill.
- Step Therapy Report - also part of
our normal audit procedure. This report verifies the processing
where the plan design requires one drug before another can be
filled.
- Proton Pump Report - with this category
at the top of your expense per category, this report examines
and defines savings with the use of OTC coverage.
- Generic Statin Report - also at the
top of your expense per category, this examines the use and defines
the savings of movements to category generics.
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