PMSI Launches Customized Pharmacy Benefit Management Program for Unique Claims

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ClaimSelect is a flexible workers' compensation Pharmacy Benefit Management program tailored for excess carriers, Third Party Administrators and settled claims administrators.

PMSI, one of the nation’s largest providers of specialty products, services and clinical services for the workers’ compensation industry, announced today the launch of ClaimSelect, a flexible Pharmacy Benefit Management (PBM) program tailored to accommodate the unique needs of excess carriers, Third Party Administrators (TPAs) and settled claims administrators. ClaimSelect allows individual claims to be enrolled in a customized PBM program that will best meet the goals of the claim, including financial management and clinical oversight programs. As a result, an average 25-30% savings in pharmacy costs can be achieved.

“ClaimSelect addresses the pharmacy needs post-settlement, high exposure, and excess claims,” stated Rey Quinones, PMSI’s vice president of strategy and product development. “These types of claims require efficient management in order to monitor utilization, maximize medical outcomes, and mitigate cost.”

Once enrolled in PMSI’s PBM program, claimants are able to receive medication through PMSI’s network of nearly 65,000 retail pharmacies nationwide and its industry-leading mail order program. Payors receive the benefit of PBM-discounted savings, as well as simplified claims management, administration and access to reports.

Additionally, for excess and high exposure claims, payors have the option of applying clinical oversight through PMSI’s MedAssess™ program to manage appropriateness and utilization throughout the claim lifecycle. MedAssess is PMSI’s enterprise-wide suite of clinical programs that work across all stages of the claim lifecycle to contain costs, reduce the risk of poor health outcomes, and promote injured worker health and wellness. MedAssess programs are designed to clinically monitor and assess proper utilization and appropriateness of therapy based on the progression point of the claim. Network pricing and clinical oversight promote cost containment and result in significant pharmacy cost savings.

“PMSI is able to move individual claims to this program with no interruption in benefits and transaction processing rules that can be customized to each claim’s unique needs through PMSI’s state-of-the-art technology,” said Quinones. “Clients will be provided with reporting capabilities that will allow them to get a complete view of claim activity, with a focus on measuring outcomes, regardless of claim administrator.”

About PMSI:
Founded in 1976, PMSI is a leader in developing solutions to control the growth of medical costs in workers’ compensation. As one of the nation’s largest and most experienced companies focused solely on workers’ compensation, PMSI delivers proven solutions for cost containment across the claims lifecycle. PMSI’s solutions for Pharmacy, Critical Care, and Settlement Solutions deliver quantifiable results and improve the quality of care for injured workers. PMSI provides its customers with the innovation, focus, expertise, analytics and technology needed to successfully deliver workers’ compensation benefits. For more information, visit http://www.pmsionline.com or call 877.ASK.PMSI.

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Jan Luongo, APR, CPRC
PMSI, Inc.
(813) 318-6810
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