FAQ

Frequently Asked Questions

These FAQs provide a better understanding of Veridicus Health, our services, and healthcare concepts. They provide basic information, sometimes about fairly complex topics, and will often link to more detailed information.

Veridicus Health provides comprehensive and customizable pharmacy solutions. We are industry leaders in clinical care management, MTM and PBM services for commercial and Medicare Part D Plans.

We are committed to providing exemplary service while maintaining lowest net cost. This is achieved through full-transparency, increasing generic utilization, and access through appropriate delivery channels.

Veridicus means Speaking Truth. Speaking Truth is our corporate philosophy and exemplifies the type of honest and complete information you will always receive from us.

We focus on integrating auxiliary healthcare services into one cohesive solution, empowering members to make informed decisions regarding their healthcare, and easing your administrative burden.

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We define transparency as full-disclosure of all revenue sources and acting with integrity in every aspect. Many PBMs define transparency differently which results in a misalignment of incentives that is financially rewarding to the PBM, but penalizes the plan sponsor and member. We believe that transparency was best described in the October 2006 edition of Benefits & Compensation Digest. We have embraced this definition of transparency into our corporate philosophy:

True transparency is a combination of decisions and business practices, beginning with full disclosure of all revenue streams and furthered by an auditable commitment to pass through all discounts and revenue streams to the plan sponsor (excluding the negotiated administrative fee). Additionally, true transparency serves as a foundation for effective alignment of incentives, including adherence to clinical plan administration practices that support the plan sponsor and its program management.

Without these cornerstones of true transparency, there are varying levels of opaqueness that cloud the business relationship, ethical conduct and ultimately the performance of the PBM.

October 2006, Benefits & Compensation Digest

Transparency aligns our incentives with those of our Clients. We charge a flat administrative fee, so there is no incentive for us to increase utilization or influence the dispensing channel (force mail order). By charging flat fees for administrative services, our Clients are better able to manage their benefits, save their members money, and meet their fiduciary responsibilities.

Most PBMs offer rate guarantees. This approach drives up costs because PBMs will adjust prices to manage the guaranteed rate rather than passing along the lowest cost to the plan sponsor and member. Through our transparent model, we pass through the lowest possible price to both our Clients and members, surpassing the rate guarantees and savings that other PBMs deliver. We pass through the best price drug by drug, not the "best network average".

Furthermore, we don't play the games that other PBMs play. A generic, is a generic, is a generic. It's just that simple.

The most effective course of treatment occurs when the patient is engaged and adherent to their prescribed therapy. Our program focuses on empowering patients to take charge of their own healthcare. This is accomplished by providing patients with the knowledge and support necessary to make informed decisions.

Our program provides telephonic MTM services to patients in the privacy of their own home. This provides a safe and confidential atmosphere where patients can open up and discuss personal concerns. Furthermore, when patients are home they have access to their prescription medications, OTC items, herbal supplements and any other essential oils or therapies they use. This provides a holistic view of the patient and our pharmacists are able to make recommendations based on complete, rather than partial information.

Every consultation includes an in-depth discussion about each medication; how it works, what conditions it treats, any side effects the patient could expect, and a discussion around the cost of the medication, as studies have shown that the cost of medication has a direct correlation to adherence. Our pharmacists work closely with each patient to set goals, provide education, and make therapy recommendations as appropriate.

Our MTM program is unique because it focuses on providing excellent care for each patient we manage. Each clinician is trained to focus on individual patients and aiding each person in their care management. Veridicus Health is the gold standard for MTM and Care Management programs. We follow industry best practice guidelines enhanced by our higher standards of patient care.

Although we use metrics such as CMR completion rates and cost avoidance to measure performance and savings, we know that true success is only achieved when we have made a beneficial impact on a patient's life.

Comprehensive Medication Reviews (CMRs) evaluate all of a patients medications including prescription, over-the-counter and herbal products. This provides a holistic approach to patient care which in turn decreases overall health care costs.

Targeted Medication Reviews (TMRs) evaluate a therapeutic problem that a patient may be having. This is a quick and efficient way to provide excellent patient care and solve a problem that may prevent further hospitalization or ER visits.

We believe that both CMRs and TMRs are important elements to providing a comprehensive evaluation of a patient's condition.

Some MTM programs focus primarily on TMRs because they are easily performed through electronic queries and do not require intervention from a clinically-trained pharmacist. We believe that TMRs provide an essential aspect to any MTM program. However, an effective MTM program must place an emphasis on CMRs in order to maximize economic value while maintaining personalized, clinical-focused interactions with the members.

We qualify as many patients as we can and then complete a personalized CMR with each patient.

Our MTM program was built upon the foundation of providing the best care to members, which in turn, improves Star Ratings and Display Measures. During each of our MTM consultations we address a wide variety of aspects including diabetes, vaccinations, hypertension, osteoporosis, metal health, and high risk medications. Each of these areas is part of a Star Rating or Display Measure for Part C or D. The MTM conversations between our pharmacists and your members address medication adherence, patient self-care, patient testing, physician testing, and goals. Our clinical pharmacists review the patient’s information to ensure that there are no harmful drug-drug interactions, eliminate any inappropriate or non-standard dosing, and achieve higher than average MTM completion rates for CMRs. Even though display measures do not have a direct impact on Star Ratings, we believe it is important to incorporate these elements to deliver superior patient care.

Through this multi-faceted consultation, patients are armed with more knowledge to help them achieve better health, which equates to higher Star Ratings and more cost savings for Plans.

Spending on specialty drugs is projected to surpass sales of traditional medications by 2018. Don't let these changes catch you (or your pharmacy budget) off-guard.

From the ever growing field of oncology to orphan diseases like Homozygous familial hypercholesterolemia, the experts at Veridicus work with you to implement one of our many specialty programs and customize these programs to meet your needs.

Our RightStart program empowers patients to make decisions and provides them with the tools and resources they need to navigate treatment options and ensure that the right drug gets to the right patient at the right time.

DOWNLOAD Read about our RightStart™ Specialty program here.

Furthermore, our Specialty Atlas tool helps eliminate the confusion of coverage between pharmacy and medical benefits, identifies the most cost-effective delivery channel, and facilitates communication for your provider relations team, taking the confusion and frustration out of specialty drugs. The Specialty Compass Program enhances your savings through proper channel management and benefit design.

DOWNLOAD Read about our SpecialtyCompass™ program here.

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