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While it's typical to ask for a minimum of 60 days to complete implementation, we often implement new plans in considerably less time. The key is client collaboration, a solid work plan and our experience. Read on to learn more about:
Your Team
Other PBMs have an implementation team that handsoff the account to others once the plan is in place. Not Serve You. We assign an account manager who is with you from day one of the implementation process and remains with you for the life of the account. Other management from our operational departments are also involved, yet operate behind the scenes and work through your account manager.
Your account manager will:
- Review current plan design and provide recommendations on the plan to be implemented at Serve You, which may mirror the client's current plan or incorporate new options.
- Work with each client to complete our Group Implementation Guide, which outlines the complete prescription drug program to be implemented.
- Coordinate efforts with other vendors (e.g., third party administrator, HR manager).
- Oversee Serve You's internal efforts to ensure a smooth implementation including quality assurance steps, system or database loads, eligibility loads, and communications to our call center.
Communicating to Members
Even prior to a new benefit plan being implemented, Serve You staff are available to visit clients and provide an on-site presentation to their employees regarding upcoming plan changes for members. When the final plan design has been determined, Serve You designs and develops a number of communication pieces for distribution to members, including:
- A new member brochure containing an introduction to Serve You and a description of the services
- Formulary lists
- Information about generics usage
- ID cards
Claims Processing
Immediately upon being awarded the business, Serve You personnel work closely with clients to develop the benefit design parameters, including covered vs. non-covered drugs, prior authorization limitations, DUR parameters, etc.
Custom & Restricted Pharmacy Networks
Custom and restricted networks can be created upon request. To help determine network needs, Serve You can perform a full disruption analysis. If necessary, we would actively recruit additional pharmacies into our network. Generally, pharmacies can be contracted within a short period of time, with most pharmacies contracting with our network within 48 hours.
Data Exchange
Serve You provides an eligibility file layout to the client's IT staff and defines the frequency and format requirements. A test file is requested to verify the data mapping and to view the results prior to "going live." Claims data file transfers are also established. The account manager works with the client to customize the file format to be used and coordinates the frequency of the transfers. At this same time, we define the levels of reporting needed, as well as any special reporting needs.
Training
Serve You staff are available to conduct training at the client's facility to educate necessary personnel on the program components, online access tools, etc.
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