Master Filter: PBM Optimization

Benefit Claim Checks

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Stop sending test claims to determine if a product is covered. Not only are you violating your PBM contract, and you are also putting yourself at risk for an audit. Instead of test claims, you can use benefit claim checks to see what is exactly covered for your patient for one or multiple drug classes. […]

A Better Secondary Wholesaler

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Purchasing a majority of generics through your primary is leaving $10,000, $20,000, or even $30,000 in profits on the table EACH MONTH! When you purchase large amounts of generic drugs through your primary, you are killing your cash flow and reducing your profits. We all know that the big primaries are not our friends. What […]

Solubiomix Niche Products

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I wanted to share with you my favorite products from Solubiomix. If you can find just a few patients that would clinically benefit or you could reduce their out-of-pocket costs with these, then it is a win-win-win! #1 Clemastine Syrup – Prescription allergy medication that is good for seasonal or chronic allergies and many dermatitis […]

Primary Wholesaler Alternative

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I am going to be bold here. Your primary wholesaler is screwing you more than you realize. They are not only harming your cash flow, but they are also reducing your profits because you are not getting the lowest price either. We all know that the big primaries are not our friends. What most pharmacy […]

Optimizing Pricing Tables

Throw out everything you think you know about maximizing your reimbursements from PBMs. My mind was blown back at the beginning of 2021 when I first spoke with Robbie at Pricing Systems. I was always taught that you program your PMS to bill huge amounts to the PBMs to get the most reimbursements. It turns […]