Client focused and technology driven benefits optimization
Every day, we strive to help our clients be proactive and make better clinically-based, financially sound, member-centered decisions.
Innovative Solutions
Our deep experience and commitment to innovation make PHG the ideal pharmacy benefits advisor for employers and benefits administrators.
Formulary Consultation
Getting the right managed formulary takes a combination of deep clinical and financial expertise. Our diverse industry relationships, along with a keen understanding of the marketplace make PHG the ideal partner for formulary management.
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Pharmacy Rebates
A properly managed pharmacy rebate program can maximize choices for prescribers and patients while keeping drug costs low. By leveraging the buying power of our network and partners, we are able to deliver greater flexibility and lower costs for our clients and their members.
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Medical Rebates
In addition to drugs dispensed at the pharmacy, many high-cost meds administered in the hospital, ambulatory center, or doctor’s office under the medical benefit are also eligible for rebates. We help develop policies and infrastructure to track eligible drugs administered at the site-of-care and capture these rebates.
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Point-of-Sale Rebates
We believe POS rebates have the potential to engage consumers in their own healthcare like they have never been before. That will ultimately drive down costs for everyone.
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Automated Claims
340B appeals are an essential mechanism to address disputes and ensure fairness and compliance. These appeals help maintain program integrity and provide a means for covered entities to seek resolution when disagreements arise concerning program eligibility, pricing, or compliance matters.
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International Services
Our team has deep clinical, financial, and international operational expertise as well as decades of industry experience. And they are constantly following complex and changing state and federal laws to maintain the highest standards of compliance for our clients.
We’re data driven, combining the latest technology and algorithms with years of clinical expertise.
We scan across manufacturers and industry partners to identify the lowest cost for any given formulary, therapeutic class, or drug and then draw on our deep clinical, financial, and operational expertise to help plans and PBMs:
• Fine tune benefit programs and formularies
• Reduce drug spend
• Improve member utilization, adherence, and wellness
Hear it from our clients
Our organization and partners appreciate working with PHG’s clinical team who keeps our team up-to-date on the latest industry trends and market changes in real time. Their educational approach is thorough and engaging, and my team feels confident in our ability to make informed formulary decisions in collaboration with our clients based on the information and data PHG provides.
TomCOO, Pharmacy Benefit Services Organization