Clinical Blogs

If you search the function of a pharmacy benefit manager (PBM), the internet responds with “an intermediary between health plans, pharmacies, and drug manufacturers to negotiate drug prices and manage prescription drug benefits.” This is true, but they can and should do so much more.

In their latest WorkCompWire Leaders’ Speak article, MyMatrixx by Evernorth experts, Brandie Traylor, Vice President of Product Management, and Cliff Belliveau, Chief Innovation Officer, discuss the “bad actors” that are hiding withing workers’ comp claims and the clinical and financial benefit of a strong FWA program.

Learn how data-driven insights can help identify and prevent workers’ comp fraud and abuse, saving costs and improving claims management.

Get expert insights, best practices and guidance from myMatrixx clinical pharmacists regarding drug safety for injured workers, their families and everyone involved in the broader workers' compensation system.

The Value of a Comprehensive PBM. There is a difference, and it is a big deal.

The Lowest Price Doesn’t Always Mean the Greatest Value especially when it comes to choosing a Workers’ Comp PBM.

Paper bills are a common practice in workers’ compensation due to out-of-network pharmacy fills, or medications dispensed from a physician office.

Albert Einstein reportedly said, “Insanity is doing the same thing over and over again and expecting different results.

Prompted by the pandemic and driven by necessity, pharmacy benefit managers (PBMs) are amid a new era of pharmacy adjudication.

Weight loss drugs aren’t often associated with workers’ compensation claims, but, in recent years, the use of GLP-1s in the commercial and workers’ comp industries have increased exponentially. It’s time to look closer at these medications and rethink their impact on workers’ comp claims.