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Pharmacy Drug Benefit System |
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| Clients | Physicians |
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Pharmacy Chains | ||||||
| Manage Company Clients | Covered Physicians | Group of Pharmacies | |||||||
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Accounts |
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Members |
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Pharmacy | ||||
| Multiple accounts in a Client | List of Members Insured | Pharmacy Covered by Plan | |||||||
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Groups | Benefits |
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Prior Authorization | |||||
| Multiple groups in a Client | Available Members Benefits | Claim Override Feature | |||||||
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Insurance Carriers |
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Planbuilder |
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Specialty Restrictions | ||||
| Insurance Carriers | Create Pharmacy Benefits Plan | Physician's Specialty Restrictions | |||||||
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Contracts |
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Drugs |
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Specialty Codes | ||||
| Set Contracts w/ Pharmacy | Pharmacy Drugs covered by Plan | Physician's Specialty Codes | |||||||
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GPI |
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Alternate Price |
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Claims Inquiry | ||||
| Manage Generic Product Identifier | Alternative Drug Pricing | Pharmacy Claims Inquiry | |||||||
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Therapeutic Class |
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Drug Formulary |
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Workfile Utility | ||||
| Classification of Drugs | Specialized List of Drugs | Import/Export Files | |||||||
| Other Tools | Documents |
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Lockout Drugs | ||||||
| Drugs Totally Excluded | |||||||||
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Simplan |
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Frequently Asked Questions | Financials | |||||
| Simulate PlanBuilder Claim | Answers to Common Questions | ||||||||
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Espaņol |
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TeleClaim++ Primer |
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Accounts Payables | ||||
| Switch language (English/Spanish) | PBM/TeleClaim++ Primer | HIPAA 835 Accounts Payables | |||||||
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Log Tracing |
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Administrator's Manual |
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Invoicing | ||||
| Trace a claim why it failed. | System Guide for Administrator | Accounts Receivables | |||||||
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User's Manual | ||||||||
| User's Guide for Admin | |||||||||