PerformRx's Medicare Programs department diligently maintains knowledge and expertise of ever-changing Part D requirements. Our proven relationship with CMS, and our experience with the Part D program, will provide clients with peace of mind relating to Medicare compliance.
Our experience with Medicare Part D began in 2006 with the inception of the Part D program. Since that time, we have leveraged our experience with CMS to provide our customers with seamless implementations of their Part D benefits and continued support. PerformRx's clients include MAPDs, PDPs, and SNPs. We provide the next generation of Part D services and support, including the following:
Medicare Part D Services
- Part D Formulary Support
- National Pharmacy and Therapeutics (P&T) Committee
- Medication Therapy Management (MTM)/ Drug Utilization Review (DUR)
- Claims Processing and Adjudication
- Explanation of Benefit (EOB) Processing
- E-Prescribing
- Pharmacy Network Administration
- Coverage Determinations (Prior Authorizations)
- Rebate Contracting and Management
- CMS Reporting (as required)
- Prescription Drug Event (PDE) Processing
- Year-End Financial Reconciliation (PDE/DIR)
Value-Added Services
- Compliance Programs
- New Contract Applications, Service Area Expansions, and Part D Bids
- CMS Audit Support
- Pharmacy Member Services
- Network Pharmacy Audits
- Quality Assurance
- Part D Reporting Submission
- Health Plan Management System (HPMS) Support
- Part D Web Site Development and Support
- Part D Marketing Materials
- CMS Guidance Updates
- GeoAccess Reports
- Part B Processing
