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PharmacyFocus is the largest digital communication platform for the pharmacy channel. Through a broad range of tools and services, PharmacyFocus works with PBMs to collect client specific pharmacy data, communicate plan updates/notifications to members and deliver enhanced technology services through multiple offerings:

Custom Pharmacy Surveys - Attestations/Data Collection

PharmacyFocus collects data from pharmacies through customized online surveys and attestations that can be built quickly and accessible to targeted pharmacies in 14 days or less.  Pharmacy surveys and attestations can be integrated with their NCPDP pharmacy profiles to display real-time data on file that needs to be validated, along with new data to be collected.

  • Customized to your client requests, built out to collect any information required and leverage existing pharmacy data resources
  • Secure or open; access can be driven by NCPDP profile and administrative user accounts
  • Standardized survey and attestation platform that is easy to use and familiar to pharmacies
  • Robust reporting, including surveyed data and pharmacy demographics
Use Case #1: California Health & Safety Code section 1367.27(l)

Background: Health plans and insurers are required to send out an annual notification to pharmacies for verification of the information contained in the plan’s pharmacy directory. PharmacyFocus provides an online attestation to confirm pharmacy directory information directly with the pharmacy.

Success Rate: PBM needed 2,321 independent pharmacies and 3,724 chain pharmacies to complete an attestation and update NCPDP pharmacy profiles (if out of date). 96% completed attestation and NCPDP updates within 60 days of the first communication to pharmacies.

Use Case #2: ADA+ Attestation to process Managed Medicaid pharmacy claims in the state of New York.

Background: Pharmacy Benefit Managers (PBMs) require pharmacies to fill out an online ADA+ attestation in order to process Managed Medicaid pharmacy claims in the state of New York. This information is required to be reported in pharmacy directories for specific New York Medicaid plans.

Success Rate: PBM needed 2,686 pharmacies to complete an attestation to update directories with an ADA+ designation. 94% completed the attestation within 45 days of the first communication to pharmacies.

Maximum Allowable Cost (MAC) Price List Transparency

Fulfill state transparency requirements and securely share your propriety MAC price lists. PharmacyFocus' secure MAC interface allows your approved pharmacies (based on network participation, geography) to access MAC prices drug by drug without providing an entire MAC price list.

  • Meet state MAC transparency requirements, while eliminating email/call center requests for current MAC prices
  • Support multiple MAC lists and separate permissions for which pharmacies can or cannot access a specific MAC list
  • Securely share current MAC prices and limit the pharmacy's ability to download an entire MAC list
  • No need to manage user accounts; secure access provided via NCPDP pharmacy profile user credentials
  • Automated updates to all MAC lists from secure data feed; support daily and weekly updates
Use Case: Provide pharmacies secure access to current MAC prices.

Background: PBMs need to provide access to current MAC pricing, as required by various state transparency laws. PharmacyFocus automates MAC data feeds on a daily or weekly cycle with participating PBMs. Pharmacies are provided access, via secure login, to current MAC pricing that is applicable to their contract(s) with the selected PBM. In addition, PBMs can maintain multiple MAC price lists and define specific business rules + permissions for each MAC price list.

Pharmacy Network Solicitations and Notifications

PharmacyFocus has established a robust document management platform to support pharmacy network solicitations and notifications. Send online, email, fax and traditional mail to any or all of the pharmacies in your network. All communications and pharmacy responses are archived in a document management system for easy access as required.

  • Unique, customized and integrated solution that combines Laserfiche's document management and Esker's document delivery solutions
  • Far more cost effective than traditional document management and delivery systems
  • Unparalleled support and deep pharmacy domain expertise

Electronic Funds Transfer (EFT) Enrollment

PharmacyFocus securely on-boards pharmacies to EFT programs and services. EFT enrollment through PharmacyFocus.com establishes a secure way to validate users, enroll and submit banking information, and validate challenge deposits to ensure correct bank account information prior to activating ongoing EFT payments.

  • Only EFT on-boarding solution integrated with NCPDP pharmacy profile user credentials to validate pharmacy ownership or administration
  • Automated enrollment process, integrated with your network management and financial systems

Content for Pharmacies

PharmacyFocus' messaging platform provides a way share digital content to the entire pharmacy channel (big retail chains, small retail chains, independents, specialty and hospitals). The messaging platform is a cost effective way to inform pharmacies of plan announcements, plan changes or any other information you are required to provide pharmacies.

  • Targeted pharmacy communications by geographic region, pharmacy type, contractual affiliation or even individual pharmacies by NCPDP number
  • Integrated with other online pharmacy tools, driving pharmacy traffic to your communications