Automated Utilization Review to Prevent Drug Abuse, Misuse and Fraud
At MyMatrixx by Evernorth, our Alert, Review and Manage (ARM)® program makes it easy for our clients to get “a helping hand” with the management of prescription drug abuse, misuse and fraud in workers’ comp pharmacy.
How does ARM work?
ARM uses an automated drug utilization review to notify prescribers about concerning prescribing patterns or clinical issues, and alternative drug therapies—and patients about safer and more appropriate uses of workers’ comp medications.
What types of communications are offered?
Concurrent drug utilization review (DUR) ensures that the dispensing pharmacist is automatically notified about potential drug issues at the point-of-sale. These communications fall into several broad categories of concern:
- Opioid Utilization
- Safety Risk Reduction
- Cost Reduction & Optimization
- Patient Education
Benefits of choosing MyMatrixx for utilization review:
- Clients may collaborate with the MyMatrixx team to determine which communications are the best fit for their needs.
- Adoption of the full suite of ARM utilization review communications assures the client that they have a comprehensive strategy for prescriber and patient retrospective outreach in place.
- MyMatrixx reviews all outreach communications annually to ensure that the language is appropriate to the target audience and designed to make it easy for a prescriber to respond with feedback outlining planned therapy changes.
- Copies of prescriber responses are sent to the client and retained for retrieval in the portal.