Pharmacy Benefit Management

Pharmacy Benefit Management: Advanced Solutions, Unparalleled Technology

MediKredit’s Pharmacy Benefit Management (PBM) is an international claims processing solution that prioritises patient-centric care. Their US-patented rules engine makes them the ideal partner for managing rising prescription drug costs globally. With a real-time switching and claims adjudication service, they serve approximately three million lives across 1691 health plan options, processing over 100 million claim lines annually.

Exceptional Speed & Accuracy: Leading the Industry

MediKredit’s Pharmacy Benefit Management is renowned for its exceptional speed, accuracy, and robustness in online real-time claims adjudication. They have achieved a well-deserved reputation for providing the fastest and most effective claims processing capability in the market. With a commitment to 99.9% uptime and a guaranteed adjudication time of less than a second, their advanced systems and hardware ensure uninterrupted service. Their proprietary claims adjudication software enables rapid response to client needs and the flexibility to innovate diverse benefit designs through rule configurations.

Driving Healthcare Innovation Solutions

MediKredit’s Pharmacy Benefit Management flexible patented rules engine empowers health plans to manage and innovate multiple benefit designs, formularies, pricing structures, reference pricing, and pharmacy networks while ensuring full patient compliance. With extensive experience in benefit and formulary design and management, as well as pharmacy network management, they offer unique solutions tailored to their clients’ needs. Their online real-time capabilities, prior authorisation and over-coding management, formulary management, network management, health plan benefit design, positive patient experience, and multiple payer-per-claim solutions set them apart in the industry.

Achieving Cost Savings

With MediKredit’s Pharmacy Benefit Management solution, significant cost savings are achieved through innovative benefit designs, formulary management, treatment protocols, prior authorisations, reference pricing, networks, and effective patient management. Their solutions drive sustainable savings while maintaining a patient-centric approach.