TPA/Insurance Company

While most PBMs base projected client savings on a per dollar , per prescription  basis, we believe that the reduction of total prescriptions costs through careful monitoring prescription utilization is, in actuality , cost avoidance rather than cost savings. In addition to usual industry cost containment efforts,  Emeric, Inc. strives to further enhance savings through:

• Strong utilization review procedures, drastically increasing otherwise missed Rejection Savings by automatically filtering submitted prescriptions for, but not limited to:

            Unauthorized Provider
            Duplicate Prescriptions
            Premature Refills
            Excessive Dosages
            Unrelated to the specific covered injury

• Mandated Generic Substitution

            Emeric, Inc. provides an aggressive generic substitution program increasing client savings by an additional 35 to            50% savings. When a generic substitution is NOT available,  Emeric, Inc.’s advanced system automatically
           selects the lowest priced Brand available.

• Largest Nationwide Pharmacy Network Available

            All major Pharmacy chains, including Walgreens and Wal-Mart, as well as most rural and independent pharmacies             included.  Non-participating pharmacies can be instantaneously enrolled with a quick phone call to Emeric,
         Inc.’s toll free customer care help desk.

• Long term and catastrophic cases automatically identified and easily transferred to PMOA Inc.’s Direct Delivery (PMOA Link)


• Customized Reporting

The Adjuster

The core of Emeric, Inc. is the adjudication program.  Claims undergo hundreds of edits to achieve accurate processing results, no matter how sophisticated the adjudication design.  The parameter driven program provides a very flexible architecture that lends itself to client customization as needed.  Our advanced software solution is coupled with the leading industry hardware and software infrastructure so that we can provide our clients with superior performance and maximum uptime.

• Established Electronic Data Interchange Connectivity:

          Successfully implementing daily direct downloads for the most accurate open/closed claims information available,           eliminating unnecessary calls to the adjuster for approval/denial.

• Emeric ScriptControl    

         Easy access to individual and group pharmacy histories, reports and historical data, which can be exported to an          easily manipulated Excel format. Real time access to modify basic claim status and information.

• DIRECT AND RESPONSIVE CUSTOMER SERVICE