A more unified vision of workers’ compensation
Pharmacy + Ancillary Benefits Management

A more unified vision of workers’ compensation
Pharmacy + Ancillary Benefits Management

Aligning People, Data, and Care

Healthcare complexity can lead to lapses in communication that impact patient care, decrease efficiencies, and increase medical and overall program costs. But we envision a better way to manage care for injured workers.

Our pharmacy and ancillary programs provide the technological infrastructure and tools necessary to put the right information in front of the right people – whether it’s the claims professional, the healthcare provider, or the insurance plan – empowering them to make better care decisions that improve program outcomes.

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Impact prescribing decisions at the source

When doctors face the unfamiliar complexities of workers’ comp, our specialized drug plans and physician outreach programs provide a much-needed framework to drive safer, more effective prescribing.


Customized formulary consultation & development

Point-of-sale step therapy programs

Prescriber monitoring & targeted communications

Comprehensive medication & case review with physician consultation.

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Connect with pharmacists at the counter

When pharmacists need to ensure safe drug therapy, we exchange drug data with pharmacies in real-time, allowing for timely insight into patients’ drug regimens. This prevents the dispensing of inappropriate therapies, protecting patients and avoiding wasteful spending.

Explore additional aspects of
our Pharmacy program

Best-in-class pharmacy network provides national, regional and local coverage

100+ customizable DUR edits applied to every transaction

Proactive pharmacy outreach to tackle prior authorizations at the point of sale

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Empower claims staff

When claims professionals are faced with important care decisions, our clinically driven tools, analytics, and customized workflows support cost-effective, clinically sound decisions that benefit patients and program performance, while also saving time and resources.

Learn about our Verticē web
portal for claims management

Right-time alerts to support authorization decisions

Intuitive analytics tools to monitor patient risk

Online claims portal with easy-to-access claims information and web-based tools

Embedded clinical guidance and pharmacist consultation

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Proactively manage new and ongoing pharmacy trends

When our customers need forward-looking insights to improve program results, we utilize an expert staff of clinicians and analysts to identify current and evolving drug trends, and bring forth differentiated trend management strategies.

Learn more about the clinical
excellence that drives our programs

Strategies for costly prescribing practices, including physician dispensing, compounds and private-label topicals

Comprehensive opioid management program

Specialty drug monitoring & recommendations

Consultative population analyses

Rx 360

Gain deeper insight into Rx drug activity.

Our Rx e360 consultative service can provide you with greater visibility into activity occurring within your claims populations.

For more information about our Rx e360 analysis, please complete this short form:

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Drive service excellence among ancillary providers

When patients require ancillary medical services or supplies, our competitive vendor network structure helps ensure the right product or service is being provided at the right price. Our ancillary benefits management program drives transparency and clinical excellence in an area of workers’ comp traditionally fraught with fraud, waste and abuse.

Learn more about our novel approach
to ancillary benefits management
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A flexible, competitive network offers customer choice in preferred vendors

Centralized platform that automates manual tasks

Prospective adjudication of all ancillary transactions

Proprietary coding structure for detailed insight into miscellaneous billing codes

Clinical strategies to manage utilization of high-cost, investigational medical products

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Navigate rapid regulatory change

When state and federal legislators turn their eyes to workers’ compensation, we provide visibility into upcoming rule changes that may impact clients – and we efficiently and effectively implement the necessary changes into their programs.

Medical and prescribing guideline updates

State drug formulary activity

Fee schedule changes

Reporting and medical data compliance

Client advocacy in the form of lawmaker engagement during rulemaking

Workers’ Comprehensive

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Sign up for our monthly e-newsletter, Workers’ Comprehensive. Stay connected with up-to-date insights on drug developments, legislation and policy changes, the latest clinical findings, industry trends, and more.