Potential Prospects

Self-Funded Organizations that lack the knowledge or resources to audit the claims payment process.

The Opportunity

Ballooning pharmacy costs combined with consistent upward trends in usage can impact your ability to grow and stay competitive. Benefit Watch delivers the expertise to control the complex web of therapies, pharmacists, pharmacy benefits and pharmacy benefit managers.

THESE OPTIONS CAN HELP YOU TAKE CONTROL OF YOUR PHARMACY BENEFITS:

Benefit Watch—Check-Up

Our basic package of review services examines the major contractual elements. This service provides a clear view of how well contract terms have been implemented. The client will understand contract term failures and financial impacts.

Benefit Watch—Action

Action examines co-payment, exclusion, and utilization controls to improve utilization management and benefit plan management actions that can result in reduced costs.

Benefit Watch—Complete

This option contains the complete set of Benefit Watch—Action reviews along with an eligibility test. It will identify all claims and associated costs for ineligible members.

The AmWINS Advantage

Benefit Watch reviews 100% of your claims associated with your company’s prescription drug benefits, including:

• Pricing
• Dispersing Fees
• Claims Basis
• Claims Summary
• Billing-Drug Cost
• Billing-Administrative Fees
• Co-payments
• Exclusions
• Eligibility
• Scripts Filled Too Soon
• Unsupported Therapy
• Maximum Daily Dosing

Benefits

• Cost recovery
• Error detection and irregularities
• Reduced future benefits spending
• Utilization management improvements and information to better manage administrator
• ERISA and benefit plan compliance
• Actionable information for strategic and financial planning
• Flexible options