Keep up with the latest information in the Pharmacy Benefit Industry each month! From articles to videos, this is your one-stop shop to staying up to date.
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Industry News and Updates
What is J-Code?
PillarRx's Vice President, Tammy Miller, shares what J-Code is and why it is advantageous to go through the pharmacy benefit instead of the medical benefit. Watch the full video below: Learn how PillarRx can
Ongoing and Emerging Drug Trends for 2021 and Beyond
In 2020, the world experienced an extraordinary amount of change including the health care system. Before we look into what 2021 has to offer, let’s do a recap of some of the biggest pharmacy
What is a Pharmacy Benefit Manager (PBM)?
What is a Pharmacy Benefit Manager (PBM)? Pharmacy Benefits Managers also referred to as PBMs, are third-party administrators of prescription-drug programs for payers, such as private insurers, and Medicare Part D plans. PBMs act
[Case Study] Delegation Audit Services
PillarRx completed an Annual Delegation Audit on behalf of a health plan client. This health plan client has over 200,000 members across Medicaid and Medicare lines of business. PillarRx reviewed the PBM’s eight delegated services. Below is a
Medicare Part D – Formulary Submission Process
Health plans and clients offering Medicare Part D to its members should have some level of oversight on the formulary submission process. This oversight is important to ensure that the formulary adheres to the
PBM Certifications – What are NCQA and URAC accreditations?
Selecting the right PBM partner to support and manage prescription drug benefits for your membership involves more than just looking at financial terms. PBM vendor selection also includes evaluating the quality and compliance of
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