We developed myMatrixx 360° to serve the complex challenges of managing workers’ compensation claims. Our technology provides claims professionals with a single online tool to manage pharmacy and clinical programs in a secure environment. With innovative technology we designed a unique web portal that provides full access to critical information to better manage costs, utilization and clinical concerns.
Our client web portal provides access to the entire life cycle of a claim from first fill to the closing of the claim. Claims managers can easily manage authorizations and view customer service notes and billing information. With electronic connectivity to our retail pharmacy network, eligibility is managed in real time increasing network compliance. By capturing all claim data, myMatrixx provides detailed reporting on program performance to track savings and network penetration. Standard reporting packages are available in real time and custom reports are available with no extra costs to measure areas unique to an injured worker population. Claims managers also have visibility to paper bills which are integrated into myMatrixx 360° for better management and drug utilization review.
myMatrixx 360° continuously monitors clinical concerns to keep you informed throughout a claim. Our clinical program utilizes predefined guidelines for workers’ compensation at the point of sale to manage concerns such as early refills, excessive dosages and unrelated medications. Additionally, we monitor injured worker populations on a daily basis for adverse trends with the Alert, Review and Manage (ARM)® program. Automated by myMatrixx 360°, the ARM program examines claims for inappropriate use of drugs such as Actiq or Fentora and excessive use of typically accepted drugs such as skeletal muscle relaxants. When further evaluation is needed for a specific injured worker, our system prompts a recommendation for a Drug Regimen Review by our clinical team. Our proactive clinical approach combined with the advanced technology of myMatrixx 360° reduces costs and supports an injured worker’s faster return to work.
The proprietary myMatrixx Mobile℠ app is the first tool designed for both claims handlers and injured workers to manage workers’ compensation claims. Now adjusters and case managers can manage pharmacy claims directly from their smart phones. Key functions available in the myMatrixx 360° web portal are available in this mobile tool, providing a secure environment to manage workers’ comp claims.
TechnologyPlus® is a unique approach that combines 24/7 service, advanced technology, and innovative clinical programs to delivery a first-rate customer experience by providing industry-leading pharmacy claims management system that streamlines your workload and saves time.
- Fast, seamless implementation process
- 64,000 retail pharmacy locations and no-risk first fill program to drive network penetration
- User-friendly web portal for quick, easy access to claims data
- Integrated clinical programs to reduce costs and improve patient outcomes
- State-of-the-art business analytics and customized data reporting
Contact us for more information about myMatrixx 360° by by filling out this form.