What We Offer
Southern Scripts provides pharmacy benefit management services for self-funded employer group health plans.
Southern Scripts will handle processing of all prescription claims including specialty pharmacy items. Claims will be processed online in a secure, cost-effective, and accurate manner. Within seconds, claims will be processed to insure the member’s eligibility, drug coverage, pricing, and detect any potential drug safety concerns. In the rare event a member is not able to have a claim processed through our online processing system, Southern Scripts will manually process the paper claim at no additional charge.
Straight-Forward Drug Pricing
Southern Scripts uses a straight‐forward and clear cut methodology in all pricing. The retail brand/generic discount is purely based on the stated discount off of Average Wholesale Price (AWP). We do not use any other components to determine the retail brand/generic discount. We invoke Maximum Allowable Cost (MAC) pricing in cases where it will produce a more favorable result over the stated retail generic discount.
We will make every effort to ensure that no pharmacy (mail or retail) is being reimbursed on any National Drug Code (NDC) other than the original manufacturer’s NDC. Southern Scripts will make every effort to prospectively deny claims for “repackaged” NDCs. Because mail order pharmacies may have business practices that avert these efforts, mail order will not be encouraged. Additionally, Southern Scripts will only partner with a select few mail order pharmacies who follow reputable business practices and allow close scrutiny of these practices by Southern Scripts.
Mail order will be made available, but is not forced. As an alternative to mail order, Southern Scripts highly encourages the use of the 90-day Retail Network. The Plan Sponsor may choose when they feel mail order is an appropriate option to incorporate into their plan or not.
Because achieving a high utilization rate of generics is essential to positively impacting a plan’s overall prescription costs, Southern Scripts maintains a Mandatory Generic Policy. If a brand drug is elected when a generic is available, the member will be required to pay the brand copay PLUS the cost difference between the generic drug and the brand drug UNLESS the physician specifies name brand only on the prescription.
Most specialty drugs may be supplied to a member by pharmacies that have joined the specialty network or through our Specialty Pharmacy Provider. Additionally, our Specialty Pharmacy Provider has extensive knowledge and expertise in the field of specialty pharmacy in order to insure your members receive exceptional care.
High Dollar Claim Review
Southern Scripts will work to ensure your prescription benefit resources are closely monitored. Any claim equal or greater than the designated amount will require a Prior Authorization. Once a Prior Authorization is completed on an initial fill, additional refills will not require Prior Authorization for a designated time period of up to twelve months. We feel this is an essential feature for ensuring sound prescription management and will never charge an additional fee for Prior Authorizations.
Regional/National Pharmacy Network
Southern Scripts provides you with the ability to define your own pharmacy networks to leverage greater cost management techniques. Southern Scripts maintains custom networks for employer groups such as the First Choice Network and the Standard Network. Southern Scripts’ First Choice Network includes pharmacies that have the highest performance standards such as high generic utilization rates, discount rates, and formulary compliance rates. Therefore, they have been selected to work closely with us to ensure that employer groups get the best possible outcomes for members using prescription medications. Our Standard Network is an extensive national network of retail pharmacies and includes all major chain pharmacies.
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.