Navigation Links
TRICAST Debuts Part D Rejection Oversight Solution for Drug Plan Sponsors
Date:8/13/2012

MILWAUKEE, Aug. 13, 2012 /PRNewswire/ -- Recent civil money penalties levied by the Centers for Medicare & Medicaid Services (CMS) against a major Prescription Drug Plan (PDP) sponsor have hammered home the fact that CMS is not taking rejection analysis lightly. To help Medicare Advantage and stand-alone PDP sponsors respond to this new vigilance, TRICAST is offering a sound PBM oversight solution.

Primary Rejection Analytics

Rejection analysis and reporting is a crucial component of TRICAST's PBM oversight process. TRICAST reviews rejected Medicare Part D prescription transactions to ensure that plan management is aligned with appropriate plan design adherence. Their trained staff analyzes rejected prescription transactions to ensure that the six protected classes (Antidepressants, Antipsychotics, Anticonvulsants, Antiretroviral, Immunosuppressants, Anticancer) are not affected. TRICAST also analyzes and reports on rejected claims during a plan enrollee's transition period.

After a rejection analysis, TRICAST is able to determine if the majority of drugs were -- or were not -- covered. They also load and display all secondary messaging sent to the pharmacy provider to further support the oversight process.

TRICAST provides their analysis in reports that contain pivot tables, analyzing the type of reject by pharmacy and its timeframe. These pivot tables not only provide a breakdown of reason codes and a summary of the count of rejects, they also allow for actionable results, review, and resolution.

Complete Transition Patient Analysis

TRICAST loads all relevant eligibility to provide a complete third-party Transition Patient analysis. Inclusion of Transaction Reply Reports (TRR), Monthly Membership Reports (MMR) and Medicare Advantage and Prescription Drug (MARx) files the system portrays any patient experiencing a change in plan design, group or enrollment as "Transition." These patients will then have a separate rejection analysis done to ensure oversight of transition compliance.

End-to-End Compliance

Including PDE and source claims on an ongoing basis enhances oversight and compliance through reporting of patient receipt of appropriate treatment post rejection. Compliance reporting supports the primary concern of patient treatment.

The TRICAST Solution

With so many alternatives to selecting Pharmacy Benefit program oversight auditors and consultants, how do you decide? The TRICAST team possesses a very unique combination of:

  • Deep domain focus on the pharmacy benefit industry
  • Highly developed software and tools tailored for PBM and program analysis that utilize 100% claim analysis
  • Experienced consulting and auditing perspective
  • Independence

Our background, coupled with our mission to address your complicated program issues with clear and actionable information, makes TRICAST an excellent partner.

About TRICAST

TRICAST, Inc. is a leading pharmacy data, analytics, and consulting firm founded in 1997. TRICAST has leveraged more than 25 years of technology and claims processing expertise, extensive client insight and a team of industry experts to offer forward-thinking, full-scope pharmacy benefit oversight solutions to our clients.

We provide audit services as the core of our business, and have assessed multiple types of pharmacy programs. Our broad experience across payors of widely differentiated size and type, combined with our focused experience in pharmacy, enables us to deliver a comprehensive assessment of pharmacy programs.  

Media Contact:

Kristin Karakis
TRICAST, Inc.
414.302.9733 ext. 245
kristin.karakis@tricast.com
http://www.tricast.com

This press release was issued through eReleases® Press Release Distribution. For more information, visit http://www.ereleases.com.

 


'/>"/>
SOURCE TRICAST, Inc.
Copyright©2012 PR Newswire.
All rights reserved

Related medicine technology :

1. BioSurplus Expands, Debuts New 8000 Square Foot Warehouse and Service Facility
2. Guangzhous Sun Yat-sen University Cancer Center Debuts MOSAIQ in the Chinese Platform
3. Viztek Debuts Upgraded Opal-Ortho Appliance; Offers Small "One Box" Footprint for Private Practices Combining CR/DR and PACS
4. Thomson Reuters Launches New Mobile Oncology Decision Support Solution for R&D Pharmaceutical Leaders
5. SolutionStart Corp. Announces John Karagiannis as Vice President of Technology
6. Stereotaxis Epoch™ Solutions Momentum Drives Strong Presence at the Heart Rhythm Society (HRS) Annual Meeting
7. Brainybrawn, Inc. announces Launch of its Web based Medical College Information Management Solution (Sanvi MCIMS), as well as Receipt of Order for Its Comprehensive Restaurant Information Management Solution for Managing Chain of Restaurants (Sanvi
8. Cardinal Health Brings Resolution to Litigation with DEA Settlement
9. Valeritas Inc. Selects dLifes New Diabetes Patient Engagement Solution For Valeritas V-go Disposable Insulin Delivery Device
10. Endo Announces Resolution of Patent Litigation with Watson Pharmaceuticals Related to Lidoderm®
11. Cardinal Health Specialty Solutions Launches PathWare™ Decision Support Transaction Solutions
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:10/4/2017)...  According to the Centers for Disease Control and Prevention (CDC), ... Urgent Care is helping communities across Massachusetts , ... offering no-cost* flu shots through the end of the month. ... regulations. ... a flu shot is by the end of October, according to the ...
(Date:10/2/2017)... , Oct. 2, 2017  Eli Lilly and ... financial results for the third quarter of 2017 on ... conference call on that day with the investment community ... The conference call will begin at 9 ... can access a live webcast of the conference call ...
(Date:10/2/2017)... 2, 2017 The Rebound mobile app is poised ... reverse the tide of prescription drug addiction. The app empowers ... intake and stepping down their dosage in a safe, controlled ... December 2017; the first 100,000 people to sign up will ... http://www.rebound-solution.com/ ...
Breaking Medicine Technology:
(Date:10/13/2017)... (PRWEB) , ... October 13, 2017 , ... ... agency serving communities in the greater Dallas, Miami, and Raleigh regions, is organizing ... fighting to overcome a rare and deadly chromosome abnormality. , After struggling since ...
(Date:10/13/2017)... ... October 13, 2017 , ... The American Board of Family Medicine's (ABFM) ... and Chief Executive Officer, succeeding Dr. James C. Puffer upon his retirement. Dr. Newton ... until Dr. Puffer’s retirement at the end of 2018. Upon assuming the role of ...
(Date:10/13/2017)... ... October 13, 2017 , ... Lori R. Somekh, founder of the ... national organization of elder law and special needs planning attorneys. “Membership in ElderCounsel helps ... provides a forum to network with elder law attorneys nationwide,” said Somekh. , ...
(Date:10/13/2017)... New York, NY (PRWEB) , ... October 13, 2017 , ... ... most influential people in business to advocate for action towards gender equality at their ... 18,000 views from around the globe, and reached a social audience of over 3 ...
(Date:10/13/2017)... VA (PRWEB) , ... October 13, 2017 , ... ... of DevOps and Agile Software Development, has been awarded a contract by the ... Blanket Purchase Agreement (BPA) aims to accelerate the enterprise use of Agile methodologies ...
Breaking Medicine News(10 mins):