Pharmacy Benefits Services & TPA Solutions
Pharmacy benefits administration and management services for self-funded employers and third-party administrators that want to optimize their member experience while improving financial outcomes.
We understand the specific pharmacy needs – and the respective challenges – of our customers in the employer, third-party administrator (TPA), and Medicaid segments. For each segment, we offer clinically-driven, evidence-based solutions to help you control costs and ensure proper utilization.
Our proprietary claims adjudication platform works seamlessly with a variety of tools designed to help you manage patient cases, support proper utilization, and increase cost efficiencies.
Change Healthcare’s Smart Commercial Pharmacy Services offer employers and third-party administrators an adaptable, flexible platform to keep up with changing consumer demands.
Services include pharmacy claims adjudication via our proprietary claims processing system, distribution channel management (retail, mail and specialty), and other business and clinical programs designed to improve member health while controlling prescription drug costs.
State Medicaid plans and their members face a unique set of challenges to achieving success in their pharmaceutical programs.
Change Healthcare takes a patient-centered, clinically driven approach to its Medicaid Pharmacy programs, offering solutions for claims adjudication, rebate management, prescriber correspondence, patient case management, and other programs.