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PBM Solutions from Pharmastar

FULL-SERVICE SUPPORT

We'll Navigate the PBM Complexities for You

The reporting and requirements of Medicare Part D grow every year, adding significant burden and forcing organizations to spend notable resources managing these processes.

Our PBM, Pharmastar, can help alleviate these burdens, providing full-service pharmacy benefit management services to help ensure your staff spend time providing care to beneficiaries, not on pharmacy administration. Our PBM tools and depth of expertise drive results, without engaging in business practices that inflate costs or hinder access to medications.

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Full-Service PBM Solutions for PACE Programs and Commercial Insurers

PROVEN PACE EXPERTISE

PBM Solutions designed to optimize Performance for PACE Programs

PACE-Association logo

As the exclusive PBM endorsed by the National PACE Association, Pharmastar provides solutions designed to meet the unique needs of PACE programs.

121 PACE Partners

Delivering quality service backed by industry knowledge and experience

66K Participants

Serving PACE participants through partnerships across the U.S.

8.5 Million Claims

Millions of gross claims processed in 2023 with capacity to quickly scale

99% Client Retention Rate

A proven track record maintaining high client satisfaction

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CUSTOMIZED COMMERCIAL PBM

Transforming PBM for Commercial Lives

Pharmastar offers customized solutions and plan designs to maximize prescription benefits. As our partner, you choose the programs to implement and the level of involvement that best suits your organizational needs. We will provide meaningful, clinically appropriate guidance and recommendations based on your specific population requirements.

INDUSTRY KNOWLEDGE AT WORK

Driving Results Through Service Excellence

The best PBMs are not always the biggest; they are the ones that make prescription drug costs easier to manage and understand. We stand apart from the largest PBMs with our unique model, which is built on key differentiators, including:

Complex administrative program expertise

Transparent pricing

Proven outcomes, including total cost of care savings

Integrated PBM and pharmacy services

Personalized medication regimens

Drug management program for opioids

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MAXIMIZING PRESCRIPTION BENEFITS

Delivering Unmatched Full-Service PBM

Our services are flexible, provide high-touch service, and enable you to achieve cost savings.

Reporting

The reporting requirements for Part D are multifaceted. To streamline workflow, we are able to create all of the CMS required reports, monitoring deadlines and providing organizations with all of the information needed for a successful submission. Our partners have access to regular utilization and financial reports, and we work with programs to develop ad-hoc reports that suit the specific needs of each organization. Plus, all Pharmastar partners have full access to the raw data available through any and all reports.

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PDE Claim Submission

Successful prescription drug event (PDE) submissions are critical to maintaining financial health and compliance requirements. With increasing CMS requirements for PDEs, Pharmastar helps organizations submit these filings. We submit PDE reports twice monthly to CMS on our partners’ behalf, and our partners receive detailed monthly reports about these submissions along with yearly filing attestation.

Adjudication

We quickly and effectively accomplish claims processing needs for partners.

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Rebate Submission

Pharmastar’s Medicare Part D rebate processing program involves close collaboration with drug manufacturers, cutting unneeded steps and providing better oversight and a clearer view into rebate claims. Our advanced technology provides plans with more timely rebate payment information and better rebate reporting to help monitor and improve accuracy. By eliminating multiple levels in the pharmacy claim, we can provide the precise data needed to help make audits easier.

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Audit Support

When a program undergoes a CMS audit, there is an abundance of policies and procedures that are under tight scrutiny. Programs who partner with Pharmastar will find reassurance and guidance through the expertise and attention of our specialists. Partnering with a fully engaged PBM like Pharmastar can be the difference between successful audits and discovering that your program could owe thousands of dollars in unplanned CMS audit discoveries.

Let’s Talk!

If you want to know more about how AnewHealth is transforming pharmacy’s impact on patient health or are interested in working together, get in touch! 

To refer a patient for pharmacy services or sign up yourself, please click here.

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