TechInHealth

A pharma company is prohibited from offering copay reductions to patients with government health insurance including Medicare, Medicaid and Affordable Care. At the time a drug is dispensed to a patient with insurance, a call to GPICS helps in enforcing such COMPLIANCE by not offering any copay reduction if the patient has government insurance.

Given a patient’s credential such as Social Security Number, obtain all (primary, secondary etc.) insurances of the patient.

Real Time Benefit Verification ensures that a patient’s pharmacy benefit credentials are current and true.

Processes pharmacy claims for a PBM on a real time basis. The claims are adjudicated based on the policies and procedures of the PBM. Bounce is completely scalable, secure, and hosted on the cloud.

Pharma companies often offer reduction in patient copay especially when new drugs are introduced. The reduction amount would normally be based on (a) whether the patient has one or more insurances or (b) if the patient has insurance, whether the insurance company would reject any payments towards the purchase of the drug stating that the drug is not in the insurance company’s formulary or (c) the amount insurance companies would pay towards the purchase of the drug. Bounce+ addresses such coordination of benefits in aiding pharmaceutical companies access the market.