PMSI Launches PharmaComplete

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This program is yet another example of how PMSI is taking its extensive experience in workers’ compensation and applying it to some of the industry’s most challenging and important issues.

Tampa, FL (Vocus) August 16, 2010

PMSI, one of the nation’s leading providers of specialty products and services for the workers’ compensation market, announced today the launch of PharmaComplete(TM), a comprehensive solution to address out-of-network pharmacy spend. The new offering builds on the foundation of PMSI’s retail pharmacy program, Tmesys. PharmaComplete was specifically designed to increase network penetration, lower costs, enable earlier clinical intervention and provide a complete picture of pharmacy spend.

“Out-of-network transactions lead to increased costs and greater administrative burdens for our clients. Over the past year, we have developed solutions—many of them new to the workers’ compensation market—to address each of the major drivers of out-of-network spend,” stated Lori Daugherty, President of PMSI’s Pharmacy division. “We have a number of clients who are already leveraging all components of PharmaComplete, and we have seen them achieve network penetration levels well above industry averages.”

PharmaComplete helps insurers, third party administrators and employers address transactions from retail pharmacies as well as non-retail settings which are often processed as out-of-network claims. In addition to increased overall network penetration and reduced spend, clients will achieve lower administrative costs while gaining a total view of the injured worker’s entire medication profile.

The major aspects of PharmaComplete include:

• Specialty Network Arrangements – PMSI has developed a series of specialty networks to capture prescriptions from dispensing physicians, occupational clinics, mail order pharmacies, and compounding pharmacies. These sources of transactions have not typically been included in workers’ compensation PBM networks.
• Automated Re-indexing – Through partnerships with two of the country’s four largest retail pharmacy chains, PMSI is able to adjudicate nearly all the prescriptions from these chains as in-network transactions.
• Out-of-Network Conversion Programs – PMSI has a relationship with the industry’s largest third-party biller to capture out-of-network transactions at point of sale, leading to earlier clinical intervention and reduction of paper bills. PMSI also uses pharmacy outreach programs and bill review solutions to minimize the presence and cost of paper bills and to drive transactions towards on-line, electronic adjudication.

“I am incredibly excited about the innovation PMSI is demonstrating through PharmaComplete,” said Eileen Auen, PMSI’s Chairman and CEO. “This program is yet another example of how PMSI is taking its extensive experience in workers’ compensation and applying it to some of the industry’s most challenging and important issues.”

About PMSI:
PMSI is one of the nation’s largest full-service providers of clinically driven services for Pharmacy, Settlement Solutions, and Medical Services and Equipment, and is devoted exclusively to the workers’ compensation and liability markets. For over 34 years, PMSI has led the industry and served as the trusted resource for thousands of insurance payers, state workers’ compensation funds, employers, and third-party administrators. Today, PMSI continues its leadership position by managing millions of pharmacy, medical services and equipment, and settlement transactions each year. For more information, please refer to the PMSI website at http://www.pmsionline.com .

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