• WHAT WE DO    • DME    • PHARMACY BENEFIT SERVICES    • ADDITIONAL SERVICES   

• PHARMACY PROGRAMS    • CLINICAL SERVICES & FORMULARIES    • CLINICAL REPORTING

Modern Medical’s in-house clinical pharmacy staff is more than happy to help you with any and all of the following services designed to give you one less thing to worry about.

(Click here to jump to: Authorization Control Options, Pharmacy Monitoring or Additional Help.)

AUTHORIZATION CONTROL OPTIONS

Modern Medical offers standard, customized and/or evidence-based formularies. Prescription authorization can be directed by individual or by group, as well as by drug, drug class, doctor, pharmacy, time frame or any combination of criteria.

All our formularies are programmed to deny brand name drugs requested by the patient when generic substitutes are available. For states that mandate generic drugs (e.g. California, Ohio and Texas), our formularies also deny brand drugs when requested by a doctor (as long as a generic is available).

Standard Formulary:

This option captures roughly 55% of medications that are typically processed through our program. See it here.

Customized Formulary:

The options are unlimited. You can limit medication authorization by criteria like quantity, days’ supply, doses per day, cost and more.

Diagnosis-Based Formulary:

Part of VeroSuite, the super-efficient set of web-based tools exclusive to Modern Medical, our evidence-based formulary is called TruScript™. TruScript™ matches almost all ICD-9 codes to specific drug plans for authorization that is case-specific. All TruScript™ drug plans follow evidence-based recommendations supported by the Agency for Healthcare Research and Quality (AHRQ). See an example.

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PHARMACY MONITORING

TruRisk™:

Also a part of VeroSuite, TruRisk™ provides clinical interventions for the following risk factors:

• Deviation from refill instructions.
• Extended proton pump inhibitor intake.
• Failure to use a generic substitute.
• Controlled substances from more than one prescriber.
• Medications from the same drug class but more than one prescriber.
• High acetaminophen consumption.
• More than three total prescribers.
• More than seven total medications.
• More than $3,000 in drug expenditures.

Drug Utilization Reviews (DURs):

Each month, a Modern Medical clinical pharmacist reviews the recent pharmaceutical activity of your claimants to identify inappropriate use, potential patient harm and/or suspected abuse. Educational letters are sent to the prescribing physicians if problems are found.

Independent Pharmaceutical Evaluations (IPEs):

IPEs are an à la carte, fee-for-service option that complements our broader drug utilization review services by offering a detailed look at any individual claimant’s pharmaceutical profile. When you request an IPE, Modern Medical will:

• Identify actual and potential medication-related health problems.
• Provide viable medication solutions that may reduce current costs.
• Reduce future drug costs where Medicare set-aside allocations apply.

Ask-a-Pharmacist

Modern Medical’s clinical pharmacists can answer all your questions to help you make educated decisions regarding your claimants’ prescription usage.

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ADDITIONAL HELP

Pharmacy Newsletter:

Modern Medical publishes a newsletter monthly to help keep your staff up-to-date on pharmacy-related issues that could affect you and your claimants.

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