Medicare Part C + D Provider

PillarRx receives 1/3 of all Medicare pharmacy claims in the country! With this data, PillarRx provides the following services to help make your Medicare Part C + D program more effective:

Part C + D Validation

PillarRx has a dedicated team of qualified professionals who have worked with most Medicare sponsored organizations. Our independent, external review satisfies program requirements by reporting results as credible to CMS and other stakeholders. PillarRx data validation is a great way to effectively assess your own performance and make internal improvements to data handling, systems and reporting processes.

Ongoing Consulting

Keeping up with CMS regulations can be challenging. We help you properly administer and align benefit designs for your Medicare Part C + D Program while remaining compliant. We ensure government requirements are being met, while increasing program and member satisfaction.

Services

  • CMS compliance guidance

  • Data validation

  • Trend analysis reporting

  • HEDIS® Compliance Audit™

  • URAC Accreditation Data Validation

  • Initial Validation Audit

  • Independent Medical Review

  • Quality Payment Program Resource Center

  • Health IT Extension Program for Wisconsin Medicaid Providers

  • Privacy & Security

  • External Quality Review

  • Quality Improvement Consulting

  • Continuing Education

References

“We’ve been working with PillarRx for several years for our annual Part D Data Validation project. The onsite audit was very useful and allowed our plan to ask questions and explain our processes. The feedback given to us from PillarRx was prompt, helpful and will be easily implemented by our team.”

“PillarRx has managed administrative processes for our Medicare Part D program since 2008. They have proven their value by providing innovating solutions to our pharmacy benefit challenges. Prior to partnering with PillarRx, our spending was out of control. They quickly implemented cutting-edge strategies that allow our plan to maintain a benefit program for our employees and retirees, that’s kept our trend below the national average.”

Let’s Work Together

Our practical guidance can help you create customized PBM solutions to help you maximize your financial outcomes, eliminate pharmaceutical waste and abuse, and increase member satisfaction.

PillarRx Consulting Pharmacy Benefit Solutions Logo

Contact us:

10700 W Research Drive Suite 3,
Wauwatosa, WI 53226
(844) 377-4246