Standard Programs And Services Covered By Administration Fee:

Southern Scripts Standard Operating Procedures

Southern Scripts’ pricing is simple and straight-forward. We have one all-inclusive administration fee that covers all standard services including the following:

  • Claims Adjudication
    (online and paper)
  • Implementation
  • Account Management
  • Member Eligibility Loads
  • Member ID Card Production
  • Clinical Programs – Prior Authorization, Step Therapy, DUR
  • Medication Therapy Management
  • Specialty Program
  • Formulary and Rebate Management
  • Customer Service/Pharmacy Help Desk
  • Member Engagement
  • Member Web Portal
  • Pharmacy Network Management
  • Custom Network Development
  • Provider Reimbursement
  • Mail Order / 90-days at Retail
  • Detailed Reporting and Analytics
  • Pharmacy Benefit Modeling and Consulting
  • Integration with Medical, Disease Management, Case Management
 

Services that are considered optional “add-on” programs through an outside vendor are at anadditional cost. Southern Scripts will pass-through those costs to the Client. Examples of “addon” services include:

  • Retiree Drug Subsidy (RDS) Program Administration - InTech
  • Independent Medical Reviews
  • Third Party Pharmacy and PBM Audit Services - Crystal Clear Rx
  • Evidence-based Medicine program – RxResults

Southern Scripts claims adjudication system can interface with most third party vendors should a client have specific needs or programs.

Per Claim Fee

An established “Per Claim Administration Fee” is collected on all paid claims processed through Southern Scripts. The Per Claim Fee does not apply to any reversed or rejected claims. This method of pricing allows for your company to only pay when our services our utilized.

Rebate Allocation

Southern Scripts discloses and accounts for 100% of rebate dollars. We pass-through 100% rebates to the employer/plan sponsor. Southern Scripts does not retain any rebate dollars since 100% goes back to the employer/plan sponsor.

Clinical Programs:

Southern Scripts employs a variety of clinical programs designed to help plans manage drug utilization and promotes the use of drugs with the lowest net cost to the plan. Drug pricing alone will not ensure savings are realized. Savings to a plan are mostly achieved through well-designed and appropriately targeted drug management programs. Southern Scripts leverages its unique knowledge base of retail pharmacy, clinical pharmacy, and benefit management to design programs that will influence drug mix and truly drives savings.

Southern Scripts uses a fully automated system with very robust edits that are individualized for all clients. There are no charges for customizing edits. Southern Scripts has a host of standard prescription edits including, but are not limited to, Quantity Limits, Day Supply Limits, Percent Consumed, Max Dollar Amount, and Age/Gender Restrictions. Additionally, our clinical pharmacists design and manage Prior Authorization and Step Therapy Programs. As part of our standard services, our clinical pharmacists also perform Medication Therapy Management (MTM) reviews for targeted high cost and/or high risk members.

See how your plan would perform with Southern Scripts - request your complimentary Prospective Cost Analysis and Plan Checkup.