Press Releases
Regence Selects RelayHealth Pharmacy Benefits Management Solution to Service 3 Million Members
ProPBM software provides real-time pharmacy benefit administration across multiple plans
ATLANTA, August 12, 2008 — RelayHealth, the leading provider of healthcare connectivity services, announced today that Regence, the largest health insurer in the Northwest/Intermountain Region, has selected RelayHealth´s ProPBM software. Regence will use ProPBM to support the management of pharmacy benefit programs accounts in Oregon, Washington, Utah and Idaho, as well as its nationwide accounts. Regence serves 3 million members as Regence BlueCross BlueShield of Oregon, Regence BlueShield (in Washington), Regence BlueCross BlueShield of Utah, and Regence BlueShield of Idaho.
ProPBM employs a secure real-time online transaction processing (OLTP) engine to process prescription drug benefit claims data efficiently and instantly. Its customer–controlled intelligent rules enable the efficient real–time management of the following: complex formularies, varying co–pay strategies, accumulated benefits, pharmacy networks, clinical edits, step–therapy protocols, drug utilization review, and complex reimbursement schedules for multiple drug benefit plans simultaneously.
“Our goal in partnering with RelayHealth is to create a flexible and readily accessible claims processing system that enables us to provide an optimal member experience,” said Helen Sherman, Pharm.D., chief pharmacy officer of RegenceRx, Regence. “The ProPBM application suite supports this goal and integrates well with other Regence systems. It also institutes quality controls throughout the claims adjudication process.”
In selecting ProPBM, Regence cited two solution features-configuration transparency and a robust test environment –that are important to their business. Other notable solution features include:
- Unique “strategies” to define and edit specific components of individual benefit designs
- A secure front-end application that enables authorized, HIPAA–compliant access
- Windows®–based graphical user interface (GUI) front–end to easily and effectively set up, view and maintain benefit parameters as well as review patient and transaction information
- Customizable functionality to administer step–therapy protocols and drug utilization review (DUR) initiatives
“We are very pleased to have Regence join the growing number of clients using RelayHealth´s ProPBM system,” said Dave D´Altorio, general manager, RelayHealth Prospective Health Services. “The fact that the system was selected after a long and intensive review further validates ProPBM as the premier enterprise application for pharmacy benefit management organizations.”
About Regence
Regence is the largest health insurer in the Northwest / Intermountain Region, serving three million members as Regence BlueCross BlueShield of Oregon, Regence BlueShield (in Washington), Regence BlueCross BlueShield of Utah and Regence BlueShield of Idaho. Each plan is a not-for-profit independent licensee of the Blue Cross and Blue Shield Association. Regence is committed to improving the health of our members and our communities, and to transforming our health care system. For more information, please visit www.regence.com.
About RelayHealth
RelayHealth, McKesson´s connectivity business, operates as a neutral partner in an open network environment, offering connectivity services and integration among all organizations, systems, and solutions. Its intelligent network is designed to streamline clinical, financial and administrative communication between patients, providers, payors, pharmacies, pharmaceutical manufacturers, and financial institutions. RelayHealth works to accelerate the delivery of high-quality care and improve financial performance through solutions such as online consultation of physicians by patients, electronic prescribing, point-of-service pharmacy claims resolution by payors, pre-visit patient financial clearance by providers, and post-visit provider bill settlement by payors and patients. RelayHealth securely processes more than 12 billion financial and clinical transactions annually. For more information, call (800) 778–6711, or visit our Web site at www.relayhealth.com.
MEDIA INQUIRIES:
Samantha Meese
Regence
(503) 225–5332
Samantha.Meese@regence.com
Janeen Cook
RelayHealth
(770) 237–7918
Janeen.Cook@relayhealth.com
