Over 6 million pharmacy prior authorizations completed in under 24 hours.
Our value helps stabilize the foundation of your program and improves beneficiary care
The healthcare landscape is constantly changing. Government-sponsored healthcare programs need an independent, objective clinical partner, powered by compliant technologies, to help them stand strong against the financial and regulatory waves of the future.
We deliver targeted support across
multiple areas of pharmacy management
Accountability: Establish and maintain appropriate pharmacy spend through increased oversight.
Setting Goals: Identify your fiscal and operational dependencies and ensure necessary separation of duties to drive objectivity and maximize value.
Clinical Criteria: Reinforce appropriate utilization with current clinical guidelines and standards of practice.
Having a dedicated team of clinicians by your side enables you to confidently manage healthcare industry trends, regulation compliance, and relationships within your provider and member community.
Acentra Health delivers:
- Improved healthcare outcomes through standardized, vetted clinical criteria for both prior authorization requests and retrospective drug utilization reviews
- Recaptured resources on your team through our administrative and clinical support for pharmaceutical research and data analysis
- Increased accuracy of program assessments based on industry benchmarking
- Greater awareness of solutions to solve the challenges of your program
- Proven clinical knowledge base from a dedicated staff of pharmacists, nurses, and pharmacy technicians
Accessibility
We make data accessible by combining data from disparate systems to help you ensure appropriate and consistent care for your members.
Flexibility
Our criteria set is flexible, allowing us to be responsive to the specific needs of your program.
Actionable Reporting
We deliver reports that highlight gaps, opportunities, and trends, so you have all the information necessary to make more informed decisions.
Education
We allow programs to build an information-rich, non-confrontational dialogue with providers to enhance quality of care.
Without the ability to gather information about program effectiveness, agencies risk increased pharmacy cost and decreased quality of care. Our RDUR solution allows you to identify potential therapy gaps and guide your provider population in healthier prescribing practices.
Acentra Health delivers:
- Greater visibility into the health of your pharmacy management program
- Deeper understanding of the effect of program activity on drug use trends
- Efficient, secure access to your pharmacy and medical claims data in a single tool
- Improved therapy management for population health
- Stronger relationships with your provider community
Consistency
Because the system is
fully-automated, every determination is made objectively, based solely on the available data and configured criteria in the system.
Speed
RxPert® adjudicated more than 6 million requests in 2019 with average turnaround times of half a second across our client base.
Ongoing Review
RxPert reviews each potential dispensing of a medication to ensure the patient continues to meet criteria.
Cost Savings
Proven return on investment studies illustrate millions of dollars saved annually without risking patient health.
Care Coordination
Leveraging cross-disciplinary insights to create a full-scope view of patient health.
Case Management
Identifying and improving outcomes for high-risk, high-cost beneficiaries.
ABSENCE MANAGEMENT
Tracking and analyzing employee absences to identify trends and opportunities.
EMPLOYEE ASSISTANCE PROGRAM (EAP)
Supporting employee wellness and productivity with comprehensive services.
Utilization Management
Providing the right patients with the right care in the right setting — every time.