Payor Solutions

Navigating patients to healthier outcomes and your brand

Affordability
Solutions for prescribers and drug service providers that deliver value-added services to their patients
Patient cost-sharing support programs
Free drug programs
Pharmacy and medical benefit solutions that work for all sites of care
Reimbursement processes that work for all sites of care: pharmacy claims, debit cards, vouchers, replacement products, and more
“Direct to patient” reimbursement

Access
Infinite channels of distribution designed in collaboration with all interested stakeholders
Affordability offers accessed through physician practices, point of care facilities, web sites, patient assistance programs, and more
Help Desk assistance for patients, prescribers, and drug service providers seeking support for all forms of payment, our programs, and enrollment
Free drug programs that distribute through all pharmacies, and offer a replacement product to providers who have accessed their own stock

Adherence
Meeting demands for cost-efficiency, expedited delivery, and product support
Program and data analytics that drive continuous performance improvement
A specific focus on speed to therapy
Helping to ensure access to avoid treatment gaps
Clinical services, education, patient assistance, and product knowledge
Market Access:
Optimize your strategy for success
We create high-performing and cost-effective market access programs in collaboration with an extensive network of industry experts.
- Address strategic program development and tactical execution that is informed by a wealth of market access experience.
- Drive market access based on your payer marketing strategy by identifying and connecting you with key PBMs, other benefit administrators, and MCO’s.
- Realize success with a go-to-market strategy and message that focuses on coverage, coding, affordability, wholesale and provider channel management, prescriber support, and more.
- Develop and continually evolve market access strategy and execution by conducting research into payer coverage, pricing, payer value propositions, contracting, and more.
- We support market access with a robust market message and highly integrated product support services that are aligned with your pricing, competition, and strategic goals.
We focus on delivery:
No patient left behind
Today, delivery of care is a diverse channel of options that must take the patient’s overall needs into consideration to ensure they receive treatment and remain adherent.
- Access to a network of informed and consumer-friendly pharmacies and sites of care
- Hub services for patient care, support, and speed-to-therapy
- Mail order and central fill pharmacy services to lower costs (for all) and improve workflow
- Clinical service options for awareness, compliance, product information, adverse reactions, enrollment, and patient assistance programs

Infinite Information
Data from all sources, available on-demand to advance your brand in the marketplace
Aggregating information from all payment facilities
Connecting and engaging all stakeholders for improvement in program operations
Tools to evaluate market share, the evolution of your affordability programs, and the specific needs they serve in each market

Transparency
Disclosure and access to data that enables our clients to compete in a complex and strategy-driven universe
On-demand access to client reconciliation, reimbursement, analytics, and claims processing
Dashboard displays of real-time NDC activity, monitoring the performance of your programs
Custom reporting so you can see performance data that is important to your specific program and competitive landscape

Remittance
Solutions that connect all the dots
Covering all payment resources accepted by prescribers and drug service providers
Electronic claims processing with an open network to 66,000 pharmacies nationwide
Debit card management and processing: Coordination of Benefits Card, Discount Cards
Help desk support for quick turnaround of manual claims submission
We’ve got the power
ICP, the InfinityRx engine for claims processing, is a technologically advanced adjudication system. We set a higher standard to support Patient Service Programs (PSP) that optimize brand performance. Information in real-time. Reports are customized. Access it all on-demand and make quick changes to accommodate compliance, challenges, and deliverables.
Branding Tools
- Custom dashboards to track brand performance and financials
- Data captured in real-time offering customizable robust reporting of program activity
- Track brand performance across all stakeholder activities
- View claims processing and monitor program activity in real-time
Accessibility
- Log into Azure Cloud, 24/7
- Ability to process 25 million claims per month
- Reach an open network of 66,000 pharmacies nationwide
Flexibility
- Client and patient-centric technology designed to serve
- Processes primary, secondary, and tertiary claims
- Make quick front-end changes to accommodate compliance, challenges, and deliverables

Fraud, waste, and abuse oversight and protection
We examine and control all claim activity from all sites of care with a suite of program integrity services.
- Two-factor security processes to confirm compliance of government patient exclusion requirements
- Claim evaluation for anomalous activity and patterns that indicate FWA, accompanied by acts of security
- Monitor and identify primary claims processed using discount cards
- Real-time, front-end capabilities permit for inclusion/exclusion of claims for cost-sharing and voucher programs