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User friendliness

The OneArk™ system's web-based graphical user interphase (GUI) provides ease of use from the ground up. The navigation is very intuitive and standardized through all of the different user screens.

The OneArk™ System Suite has been designed with QA in mind. It has a built-in Testing/QA environment that lets you create, modify and test formulary, benefit, costshare and network designs in a separate environment, giving you total control from benefit setup to the processing of claims using real pharmacy software without touching the production environment.

PharmPix's OneArk™ system allows you to work separately and therefore minimize errors; it also lets you do a thorough test and generate a benefit design report to validate and sign off prior to going live into the adjudication functionality. When the changes are ready to go from the Testing/QA environment into production, deployment is made with a simple "click".

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Secure system

System security is built into the design.

From the very early design stages, security was of the utmost concern, since we have to comply with HIPAA security ruling and its policies toward protected health information (PHI).

OneArk™ System Suite controls user access through role segregation. Each user will only have access to applications and to see or edit information based on his defined role. Built into OneArk™, System Security is an audit trail that lets you know who made the changes, as well as where and when those changes were made. PharmPix OneArk™ system's security assures users at all levels that only appropriate access is achieved and compliance of HIPPA is in place.

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Innovative, flexible design

Our OneArk™ System Suite's state-of-the-art innovative designs have taken many of the different challenges that are found in today's PBM industry and developed them into properties that can be easily changed to control the processor flow in a matter of minutes.

All of this is done without affecting other customers or groups, and without having to spend way too many hours of software development efforts. Changes can be made easily at every level and by different users. OneArk™ Cube lets your multi-disciplinary team collaborate to configure your pharmacy benefits package right down to the last detail.

Customers, contracts, groups, formularies, benefits, cost shares and networks all work independently and then join together to offer a fully functional pharmacy benefit in place ready to accept pharmacy claims. OneArk™ System Suite's flexible and atomic design lets you control how you pay, from a network of pharmacies to a single pharmacy within a network-based specific creative criteria that facilitates customer control.

The same goes for patient cost share structure: you can have, within the same group, a different cost share structure based on any or combination of the fields from the eligibility file or the claims transactions, giving true flexibility at the tip of your fingers without having to code these rules in.

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Fast, customized benefit builder

The PharmPix OneArk™ system was designed with input from managed care pharmacists who work regularly on customized benefit applications. Based on the experience of managed care professionals, many new benefits for different clients are variations of existing ones.

With this in mind, PharmPix built into OneArk™ Cube the Power Copy functionality that lets you copy a complete formulary, benefit, and cost share design in seconds under a new name and modify it to meet your client's need, giving you the control to react faster to your needs. Tasks that can take days to complete can now be managed in a matter of minutes using the Power Copy functionality.

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Single point of entry portal

A single point of entry makes navigating our system a snap. Based on the role of the user, once authenticated, all applications are made available in the main console. All functions can be accessed from a single portal.

Ease of use and simplicity saves time and minimizes training requirement for users.

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Real-time accuracy

The clinical interaction between PBMs and providers takes place in real time through Concurrent Drug Utilization Reviews (CDUR) where PBMs send clinical messages to the dispensing pharmacies in each transaction to prevent issues like duplicate therapies, incorrect doses, and drug-drug interactions. With time, these messages have become useless due to the inaccuracies and inconsistencies in the quality of the messages and the majority of them have no actual clinical consequences. Thus, pharmacies tend to ignore them altogether. But with PharmPix:

  1. Our state-of-the-art system avoids these inaccuracies by sending pharmacies only the messages that have real clinical consequences. Our clients have the option to set up critical CDUR (such as duplicate therapy, drug-drug interactions, etc.) as actual POS rejections. This minimizes POS noise and clutter, avoids the adjudication of controversial claims and improves the health of members.
  2. Medications like insulin, low molecular weight heparins, eye drops and a few others are prone to be processed with the wrong quantity due to the nature of the package size and/or dosage form. In its adjudication process logic, PharmPix, uses ratios between dosage, package size, quantity dispensed and days supply to correctly settle the claims and reject those with inaccurate quantities.
  3. Most pharmacy software are set to resubmit claims every time an increase in Average Wholesale Price (AWP) is detected in their database in order to increase their reimbursement. Different from other PBMs, PharmPix adjudicates those reprocessed claims at the AWP of the original date of service (DOS).
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Unique exception management tool

Our Granular Exceptions & Rules Plus tool works as a claim workflow manager. It creates exceptions to Medispan Concurrent DUR rules and manages the claim as approved by the P&T Committee. The exception can be created at any level, from GPI2 to GPI14. It can customize the outcome of the claim (reject or soft message to the pharmacies) and can add additional messages (customized) to the pharmacy. It can also send clinical alerts to clinical teams like MTMP or Care Management teams.

With the unique exception management tool, you can easily automate interactions that would normally require a prior authorization, therefore reducing call center workload and member noise.

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Access and control

Managed care and aggregator clients constantly seek access to the system as well as control. They require this for the purpose of adding new groups, reviewing plan designs and/or modeling new concepts. Client service centers seek access for checking the status, referred to as a "WISMO" (where is my order) when mail service and specialty options are in place. Through a secure system access, we offer service and technology that always places the client in the lead seat with the following access and capabilities:

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Mobility

Using the OneArk™ System Suite puts you in control. It provides on-line access to all management tools, making it easy to create your virtual call center where employees can access tools and manage your patient and their claims, from anywhere in the world and from any device, as long as they have access to an Internet connection.

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