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PROGRAM DESIGN

The purpose of the Protocol Guide is to simplify and streamline the implementation process and create a set of business rules to guide our partnership. As we go through the document with you, we will be asking you questions specific to how your claims are handled and how your business operates. Issues may be raised that have not been previously considered, and in doing so, we hope to help you avoid problems that might become much more serious down the road.

And as the 1st PBM Cloud Solution, changes to YOUR program can be made in Real Time.

We PUSH the information to the right people at the right time. Your TEAM will have more information to make more timely and well informed decisions than ever before. By taking the time to answer the questions thoroughly and with forethought to the future, we will be able to complete the system setup and provide a seamless transition.

Areas for discussion are listed below:

1.  General Client Information

2.  Group Design

3.  Plan Parameters

4.  Invoicing Information

5.  Clinical and Claims Management

6.  Reimbursement of Injured Workers’ Claim

7.  Notification & Reporting

8.  EDI, Transaction Processing & Online Access

9.  Special Instructions / Disaster Response Plan

10.  Agreement

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