Virtual Benefits Administrator (VBA) Integrations

As trailblazers in the realm of specialty drug management and leaders in Medicaid pharmacy programs, we are revolutionizing pharmacy benefit management by collaborating closely with our clients and members to provide an exceptional healthcare experience. Our organization is committed to the principle that everyone deserves access to the resources necessary for a healthy and fulfilling life. We develop mutually beneficial solutions that prioritize personalization and enhancement of the healthcare journey, ensuring that we achieve the best possible results for both our clients and members while fostering a supportive community.

Southern Scripts streamlines the often complicated landscape of Pharmacy Benefit Managers by providing employer groups with unparalleled autonomy, control, and flexibility in designing their plans. Established by pharmacists, Southern Scripts stands out as a forward-thinking pharmacy benefits manager (PBM) that seeks to transform the conventional PBM model. Our unique pass-through PBM framework and adaptable solutions enable plan sponsors to maximize savings, minimize risk, and enhance flexibility in their plan design, fostering genuine patient-centered clinical care at the most affordable net cost. The plan sponsor only pays the exact amount that the pharmacy receives, while we ensure that all discounts and rebates obtained are fully passed on at 100% to the plan sponsor. There are no hidden fees for essential PBM services, including prior authorizations, step therapy, and data reporting. Our comprehensive clinical management programs and top-tier drug formularies are designed to provide the lowest net costs, safeguarding plans against unnecessary expenditures while promoting optimal patient health outcomes. Ultimately, the focus remains on delivering value and ensuring that plans are both efficient and effective in meeting their goals.

Enhance the design and manufacturing processes to produce clearer and more impactful materials for members. Integrate and manage both electronic and printed communications to ensure that every interaction resonates more deeply with members. Simplify the establishment of provider payment preferences, guaranteeing timely payments that align with their requirements. This comprehensive approach fosters a stronger connection between members and the organization.

Safeguard the reliability of your health plan while pinpointing precise pricing with the Context4 Health Plans Suite, our versatile and cloud-centric technological framework. Experience immediate and actionable insights for detecting Fraud, Waste, and Abuse (FWA), developed by our skilled team of certified experts in clinical, dental, and health benefits. By leveraging accurate data and state-of-the-art cloud technology, we deliver a robust and defensible Medicare reference-based pricing (RBP) solution. Our platform comprises over 100 healthcare data sets, complemented by professional guidance to enhance operational efficiency and ensure regulatory compliance. Additionally, our sophisticated medical coding software is tailored to streamline claim submissions and reduce the likelihood of denials. Furthermore, the cloud-based Payment Integrity Platform harnesses our unique analytics engine to uncover coding mistakes, assess medical necessity, address unbundling, detect fraud, waste, and abuse, evaluate audit risks, and identify pricing discrepancies, all of which can significantly influence your organization's performance. This comprehensive approach not only safeguards your financial health but also positions you for sustainable success in the ever-evolving healthcare landscape.