AI streamlines pharmacy benefits, but human connection remains crucial. Employers should assess PBMs for human-led clinical decisions in prior authorizations, proactive pharmacist consultation, and personalized service. Relying solely on AI risks employee health and satisfaction. The right balance of high-tech and high-touch ensures better outcomes, cost savings, and improved patient experiences.
Recent FDA changes impact GLP-1 compounding, affecting employer benefits and employee access to weight-loss medications. Employers must evaluate coverage strategies and weight-loss platforms for long-term cost and health outcomes.
Read the BlogWe’ll break down key trends in the upcoming pipeline and provide actionable insights on how to navigate the changing landscape.
View the WebinarThere are pharmaceutical trends that happen every year, and if you aren't keeping a close eye, you may miss key opportunities.
Read the BlogThis form is used for providers to request an appeal after a coverage determination or prior authorization has been denied. Your medical provider will complete it with appropriate documentation and mail or fax to True Rx Health Strategists. Your doctor's office needs the address and fax number on the form.
View FormA Prior Authorization is the process in which information regarding a certain medication is gathered and clinically evaluated to determine if the prescription benefit plan will cover their portion of the medication cost. Some plans set limits on certain medications due to age, efficacy, cost, and availability.
If a prior authorization is needed, your doctor's office will need to complete this form. Instructions, including contact information, are included on the form.
View FormOccasionally, you may be eligible for a refund from True Rx Health Specialists if a medication was not covered initially at the pharmacy. If this is the case, simply download the drug reimbursement claim form and follow the instructions. Mailing instructions are included at the bottom of the page.
View FormIn addition to using this list, you are encouraged to ask your doctor to prescribe generic drugs whenever appropriate. This list is not all–inclusive and does not guarantee coverage.
For more information, please contact the True Rx Patient Care Team at 866-921-4047.
View FormularyIn addition to using this list, you are encouraged to ask your doctor to prescribe generic drugs whenever appropriate. This list is not all–inclusive and does not guarantee coverage.
For more information, please contact the True Rx Patient Care Team at 866-921-4047.
View FormularyMariah P.
Pharmacist