White Paper

How a PBM Adds Value to the Paper Bill Review Process — Financially and Clinically

Physician-dispensed topicals are costly and there’s no evidence that they are more effective than what is available through the more traditional distribution network of the retail pharmacy network. Why aren’t more states taking action?
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White Paper Summary

Paper bills are a common practice in workers’ compensation due to out-of-network pharmacy fills, for instance, or medications dispensed from a physician office.

“When we say ‘paper,’ it’s a generic term for anything that’s not coming to us from a real-time, point-of-sale environment, like what you’d see at an in-network retail pharmacy,” explained Viviana Brantley, chief operating officer, MyMatrixx by Evernorth (MyMatrixx).

Because these bills can come from different sources and hold different pieces of information, it may be difficult for payers to understand the amounts they are being charged, what services they are charged for, what happens if there is missing information on the bill and what is happening to the bill data.

All of that should be answered in bill review, so having the right bill review partner can make a big difference financially.

Unlike a traditional bill review vendor, MyMatrixx takes prescription bill review further as it works to eliminate administrative overhead and provide its clients with exceptional clinical management.

To learn more about myMatrixx solutions, please visit their website.

As a PBM focused on workers’ compensation, MyMatrixx is dedicated to highly proactive customer support and a full suite of data-driven pharmacy, clinical and regulatory solutions to mitigate risk and safely guide injured workers on their path to recovery.