Pharmacy Benefits

Work with our team to implement and maintain your pharmacy benefits program

Collaborate with your Argus team to develop, implement, and test new benefit structures. Our subject matter experts assist in the review of pharmacy benefit data to ensure your requests are interpreted and implemented accurately. In addition, researching and resolving of complex benefit related issues will be addressed.

• Plan Design
• Drug Utilization Review Edits
• Formulary Maintenance
• Member Copay

A quality system for benefits administration

A series of checks and balances ensures the appropriate application of the benefit requests before going into live production. A documentation trail of all communications provides accountability and a vital reference.

All requests go through a process of analysis, verification, and testing before they are considered completed. Customers receive copies of claim tests, and the customer can run their own tests against their actual benefits to provide additional verification.

Argus' Drug List application provides customers a user-friendly and potentially self-service solution to manage the drug information used in claims adjudication. Drug Lists support combinations of levels of drug classification, inline exceptions, category groupings, and multiple list types.

DUR Safety incorporates edits applied at the point-of-sale which promote safe and cost-effective medication use. The DUR Safety component incorporates five types of edits that promote safe medication use.