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.
Web Portal – Easy to Use
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 for better management and drug utilization reviews.
Clinical Oversight And Reporting
Our technology continuously monitors clinical concerns to keep you informed throughout a claim. Our clinical programs utilize 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, which examines claims for excessive inappropriate use of drugs. When further evaluation is needed for a specific injured worker, our system prompts a recommendation for One Drug Review or a Drug Regimen Review by our clinical team. Our proactive clinical approach combined with our advanced technology reduces costs and supports an injured worker’s faster return to work.