Generic Prescribing Rate
Another
aspect of care that we report to both primary care and specialist physicians
who are eligible for the incentive programs is their prescription of generic
(non-brand) drugs. Generics are FDA-approved and must be shown to be equivalent
to the brand name. These drugs are usually less expensive than the brand-name
drug and most prescription drug plans charge a lower copayment when a member
receives a generic drug, saving the member money. CDPHP calculates the
percentage of all prescriptions that a physician writes for generic drugs and
reports that information to the physician if he or she has written more than
100 prescriptions in the previous year. We also report on the rate of generic
prescriptions for specific types of drugs that have generic alternatives
available. These classes are reviewed each year and may change based upon
review of our current results.
THE EYE OPENER TO RISK MANAGEMENT OPERATIONS
MCAR – MANAGED CARE REPORTS
Timely solutions to funding, claims, pharmacy & distributions
Here are
some of the options available:
·
Control
over HEDIS requirements, alerting what measures apply to each member of the HMO
panel and most importing identifying what measures are pending per member in
the reporting period.
·
Summary
analysis of funding and expenses including expected distributions, in minutes
you know what is going on with your risk operation.
·
A
PCP Analysis that shows performance for each PCP in the network from funding,
expenditures to net amount after medical expenses. A simple and easy report
that enables you to identify and compare all PCP’s performance.
·
MCAR
produces a detailed analysis of charges payments and adjustments from
Institutional, Professional and Pharmacy claims.
·
A
key report - Summary Report showing what each member is costing the panel, a
brief breakdown of medical expenses also showing when was the last time the
patient came to the office, if ever.
·
A
detailed analysis showing all activities for every member - HEDIS measure
status, diagnosis codes with MRA evaluation plus each line item of expenses –
YOU CAN VIEW THE PRECISE COST OF EACH MEMBER OF THE PANEL.
·
STOP
LOSS verification.
·
MCAR
Reports claims module – “The ADJUDICATOR” scrubs your professional,
institutional and pharmacy claims and also prepares a contestation report
requesting adjustments from the Plan.
For more
details, please call : 305-227-2383
or 1-877-938-9311
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