Alerts are generated when member out-of-pocket costs are $15 or more and the savings opportunity is $10 or more. The alerts are designed to align with the member’s benefit structure and may include:
Therapeutic substitutions
• Switch to alternative drug on lower-tier or level of formulary
Channel
• Switch from retail to mail order (if the member has the benefit)
Day supply
• Switch from 30- to 90-day supply
If you have any questions, contact Juliette Houseman, Benefits Specialist.
No comments:
Post a Comment