ESIS PBM combines strong oversight and technology interfaces to ensure the right drugs, dosages, and durations are implemented to help save money and improve medical outcomes.
Key pharmacy solutions include:
- Customized formularies — triggered by injury code from the claim
- Clinical letter programs — ensure appropriate medication therapy
- First fill — enrolled employers are able to provide injured workers with immediate pharmacy information to avoid out-of-pocket expenses
- Clinical triggers — ESIS Clinical Resource Nurses review specific pharmacy triggers, working with the claims representative on next steps
- Pharmacy Utilization Review (PUR) — provides recommendations for medication therapy and incorporates embedded case management, resulting in streamlined and optimized care
- Compound medications — ESIS Pharmacy Impact’s clinical team identifies all compounds at the point of sale and works with the pharmacy for acceptable alternatives
- Pain management — our predictive risk scoring model identifies high risk claims for our clinical team to review in order to utilize tools to help prevent a chronic pain claim from developing
- Urine drug monitoring — provides the claim adjuster with tools to facilitate appropriate drug tests at a reduced cost, helping to provide actionable information regarding the appropriate usage of prescribed medications.