Prescription Benefit Plans

Southern Scripts offers three different options that Plan Sponsors may choose from in designing their Pharmacy Benefit Plan – RxPremier, RxTraditional, and RxCustom. Each plan design and its features are described below.

  • Initial Plan Set-Up
  • Implementation and Roll Out
  • Member Identification Cards
  • Replacement ID cards
  • Eligibility files maintenance
  • Daily electronic submissions
  • Paper submissions
  • Connectivity to online system
  • Customer Service Call Center
  • Formulary Management
  • Rebate Program
  • Member communications pieces including shipping
  • Clinical and Prior Authorization Programs
  • Weekly Invoicing
  • Pharmacy Claim Payment
  • RxRevue Reporting

Option 1:  RxPremier

  • Two Pharmacy Networks:
    – Preferred Pharmacy Network
    – Choice Pharmacy Network
  • 90-Day Retail
    – limited to Preferred Pharmacy Network
  • Mail order available, not forced
  • Southern Scripts Specialty Pharmacy Network
  • 100% Disclosure of all rebates
  • No Spread Pricing
  • Payment for Services is a flat per paid claim fee
  • Rebate Allocation
  • Mandatory Generic Policy
  • Southern Scripts Formulary
  • Three Tier Copay Structure
    – Generic
    – Preferred Brand
    – Non- Preferred Brand
  • All inclusive services

Option 2:  RxTraditional

  • One Pharmacy Network
    – Choice Pharmacy Network
  • 90-Day Retail
  • Mail order available, not forced
  • Southern Scripts Specialty
    Pharmacy Network
  • 100% Disclosure of all rebates
  • No Spread Pricing
  • Payment for Services is a flat per paid claim fee
  • Payment for Services is a flat per paid claim fee
  • Rebate Allocation
  • Mandatory Generic Policy
  • Southern Scripts Formulary
  • Three Tier Copay Structure
    – Generic
    – Preferred Brand
    – Non- Preferred Brand
  • All inclusive services

Option 3:  RxCustom

100% Customized Plan Design

  • Pharmacy Networks designed according to your specifications
  • 90-Day Retail – your choice to include 90-day retail
  • Mail order available – Your decision to include
  • Specialty Pharmacy Network – your decision to limit specialty to specific pharmacies
  • 100% Disclosure of all rebates
  • No Spread Pricing
  • Payment for Services is a flat per paid claim fee
  • Rebate Allocation
  • Mandatory Generic Policy
  • Southern Scripts Formulary can be customized
  • Copay Structure set by plan
  • All inclusive services