A smarter path to profitability
Shrinking reimbursement and high DIR fees continue to be a complex problem for pharmacists. Through our PSAO, Elevate Provider Network, we negotiate with Pharmacy Benefit Managers on your behalf to minimize the impact of DIR fees, maximize reimbursement and maintain access to patients, while providing industry-leading tools to increase operational efficiency and optimize your prescription business.
Be part of a managed care network with more than 4,600 members
Our intuitive pharmacy analytics and benchmarking system helps you make better day-to-day decisions while our experts handle a range of managed care issues for you. With this unique combination of analytics, technology and professional services, Elevate Provider Network is strengthening our members’ presence in managed care and providing a smarter path to profitability.
A multi-faceted approach to DIR fees
AmerisourceBergen continues to support a multi-faceted approach to managing the impact that DIR fees have on the independent pharmacy business:
Through our PSAO, Elevate Provider Network, AmerisourceBergen is taking a stand against excessive DIR fees. We are working diligently on behalf of our independent pharmacies to minimize the impact of DIR fees while maintaining access to patients.
We continue to advocate on behalf of pharmacies on critical legislative issues that impact their daily operations, and work to amplify the already powerful voice of the pharmacist.
We provide tools and resources, like the DIR Estimator, to help pharmacies manage the impact of DIR fees and the adjustments associated with them.
Maximize prescription profitability
Payer contract negotiations
We model and negotiate payer contracts on your behalf, using extensive data along with guidance from specialists with more than 50 years of managed care experience.
Pre and post edit services
Think of pre and post edit services as spellcheck for your claims—a quick double check to make sure your pharmacy system submits everything cleanly, with real-time edits for financial, administrative and legal compliance—and a customized suite of edits for our PSAO members.
Pharmacy performance and benchmarking services
Our industry-leading, proprietary pharmacy analytics system, InSite 2.0, analyzes your pharmacy’s performance on the underlying drivers of profitability and benchmarks against your peers. It’s a patient-centric approach rather than prescription-centric, and the interactive dashboards (like the Week-at-a-Glance report) help you make better business decisions.
MAC pricing challenges
We leverage our robust pharmacy performance and benchmarking system to identify and spot negative-margin MAC prices and file claims on your behalf, maximizing reimbursement and reducing your administrative work.
Central Pay services
Claim errors leave money on the table, negatively impacting cash flow and gross profit. Central Pay services improve cash flow visibility, are included in your membership and are fully integrated with our reconciliation services.
Improve Star Measures with actionable reporting
AmerisourceBergen makes it easy to track performance on quality measures important to health plans by providing you with a variety of helpful tools. We enable you to identify patients that are underperforming and negatively impacting your score so you can provide them additional support. You can also fax physicians for medication use interventions, show your staff the patients due into the pharmacy every day and the services available for them, and conduct MTM with one-click access to MirixaPro℠.Learn more