PBM
Customizable PBM software for plan management and claims processing
Cervey’s PBM Claims Management includes a next-gen plan management and claims processing solution that enables self-funded employer groups and pharmacy benefit managers (PBM’s) to efficiently design, manage, and process prescription benefits.
Independent of PBM ownership, this highly customizable PBM solution puts you in control of all facets of drug claims using a flexible rules engine that’s built to easily accommodate numerous variables in your plan design.
PBM Services
- Pharmacy Claim Adjudication
- Pharmacy Benefit Design
- Pharmacy Network Services
- Third-Party Administration (TPA) Solutions
- Long-Term Care PBM Services
- Self-Funded Employer Services
- Hospital & Health System Services
- Cash & Discount Card Services
PBM Advantages
- SAAS web-based technology
- 100% HIPAA compliant
- Advanced security that exceeds healthcare and privacy regulations
- SOC3, ISO27k, SOX, and PCI-compliant data centers
- Agile software built for existing and future industry needs
- Flexibility for current and future benefit configurations
- 100% pass through
- API integration
- Rules-based engine
- Service-oriented architecture
Product Benefits
Access claims in real time, with no need for costly software or licensing, using our secure, reliable systems.
Specify your unique parameters for formularies, prescription pricing, rebates, in-network pharmacies and other facets of a well-managed benefits plan.
Capture savings using the system’s built-in rebate collection and pricing processes and pass those savings on to your customers.
Benefit from Cervey’s knowledge of the entire pharmacy and PBM universe.
Build and manage formularies, in both standard and custom formats, aggregating medications from multiple pharma providers.
Customize pricing based on AWP, WAC, MAC, ACQ and other methodologies that you can modify according to your business model and needs.
Categorize medications into different tiering, pricing and reimbursement structures — including discounts and rebates.
Service, not just software
Cervey’s PBM customer support is always there. It’s a 100% real person, who is not outsourced, with real answers to your questions.
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