Dynamic Healthcare Systems Helps MAOs Validate PBM Data

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Prescription Drug Event Solution Validates and Improves PBM Submissions

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Dynamic helps its health plan clients hold their PBMs accountable for the accuracy of their drug claim submissions to CMS

Government-regulated health plans can now get third-party validation of the data submitted to CMS by their PBMs from Dynamic Healthcare Systems. The Prescription Drug Event (PDE) solution offered by Dynamic helps Medicare Advantage Organizations (MAO) reduce and resolve rejects from PBM submitted data. Dynamic Healthcare Systems, a leading provider of enterprise-wide solutions to health plans participating in Medicare, Medicaid, and Exchange programs, is offering a robust solution for Part D submittals. As pharmacy spends continue to sky-rocket, plans need solutions to control their pharmacy benefit costs and get the best possible value from their PBM relationship.

Dynamic’s PDE solution, which can be utilized by MAOs as a stand-alone service, or as a part of the entire Dynamic suite of Medicare Advantage Part C and D solutions, provide audit capabilities including PDE data, Rx claims, Part D reports, Financial Information Reporting (FIR), and Acumen reports. Dynamic’s PDE module also provides MAOs with a solution to resolve PDE encounters rejected by CMS. These capabilities are further enhanced by the involvement of Dynamic’s experienced pharmacy benefit team. Dynamic’s PDE solution provides MAOs with clear, timely, accurate and unbiased reporting on the pharmacy benefit costs and compliance risks.

“Dynamic helps its health plan clients hold their PBMs accountable for the accuracy of their drug claim submissions to CMS,” said Kathy Feeny, President and CEO of Dynamic Healthcare Systems. “This is especially important as CMS has increased the frequency of their audits in this area.”

About Dynamic Healthcare Systems
Dynamic Healthcare Systems, Inc. delivers comprehensive enterprise-wide solutions and services for health plans with Medicare Advantage, Medicaid, and Marketplace lines of business striving to succeed amid new and evolving regulatory requirements. Headquartered in Irvine, California, the company brings world-class innovations to companies serving the government-regulated healthcare population. For more information, visit http://www.dynamichealthsys.com or call 949.333.4565.

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