As famously quoted by Ferris Bueller in Ferris Bueller’s Day Off, "Life moves pretty fast. If you don't stop and look around once in a while, you could miss it.” Along with life, technology and automation are also moving pretty fast. From how we make phone calls to how we build cars, to even how we manage claims, over time, manual processes are automated to help people perform tasks faster and more efficiently, which is good because, now more than ever, we are expected to do more with less. This is especially true when it comes to formulary management, where automation and data intelligence can make the difference between timely treatment and frustrating delays for injured workers.
The Importance of Formulary Management in Workers’ Compensation
As a workers’ compensation pharmacy benefit manager, we use medication formularies to help ensure an injured worker has access to the right medication, at the right time, and at the lowest cost. Formulary management involves effectively applying these guidelines—whether state-mandated or client-determined—to automate medication approvals and quickly flag any that require further review.
When a medication is not covered by the formulary, it will require prior authorization, which pauses the process so the adjuster can review and confirm if a medication should be approved for an injured worker. All of this takes time−and time is money.
“The more PAs [prior authorizations] an adjuster must complete, the slower the process becomes,” states Cliff Belliveau, MyMatrixx Chief Innovation Officer.
When the process slows down for the adjuster it can also be an inconvenience for injured workers. “A single PA [prior authorization] requirement could result in a delay in obtaining required medications or multiple trips to the pharmacy,” stated Courtney Deck, MyMatrixx Senior Clinical Account Executive.
MyMatrixx’s Formulary Optimization Solution
In a recent WorkCompWire Partner Post, Belliveau and Deck discuss how we use data intelligence to create a better prior authorization solution by identifying opportunities for formulary optimization, which can:
- Reduce the number of prior authorizations
- Save clients time and money
- Open conversations with clients to create a formulary that adds value
Click to read more about how the MyMatrixx Formulary Optimization Solution can help you create a smarter formulary that supports the needs of your business.