Clinical Blogs

In our latest Risk & Insurance interview, Paul King, president of MyMatrixx by Evernorth, discusses why pharmacy benefit managers (PBM's) matter in workers' comp.

In recent years, an expensive treatment known as MACI has been gaining traction in workers’ compensation claims. Read more about what MACI is, how it works, and more.

When chronic disease is involved in a workers’ compensation claim, a holistic, whole-person approach to care creates better outcomes for both patients and payers.

Learn how effective pharmacy management for chronic conditions in workers’ comp can mitigate payer costs while improving patient outcomes.

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.

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.

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.

A doctor writes the prescription. A pharmacy fills the prescription. A patient gets the prescription. This straightforward process takes place every day, and most prescriptions are filled without issue and follow all the appropriate pricing and dispensing rules.

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