Customized Plan Design
Customize your plan to meet the needs of your population. Clients can set unique parameters to optimize the effectiveness of the plan and decrease spending. Potential plan parameters can contain edits and alerts, including:
- General or drug-specific clinical prior authorizations (CPA)
- Drug-specific step therapies
- Quantity limits
- Age restrictions and other DUR edits
- Max dollar limits
This allows for the verification of medical necessity of certain medications through correspondence with the prescribing physician, and is facilitated by SCL's automated prior authorization system (PAX). Our real-time claims processing platform and Dynamic Eligibility capabilities ensure that no inmate goes without access to medication.