Fast – Easy – Your Complete Workers’ Compensation Pharmacy Solution
At StoneRiver Pharmacy Solutions we understand that a pharmacist's primary goal is to improve a patient’s quality of life by designing, implementing and monitoring drug therapy, devices and services to achieve the best possible therapeutic outcome possible. Wading through paperwork, spending valuable time making calls to employers, payors and physicians to track down claims and fight for reimbursements only makes it more difficult, if not impossible, to achieve that goal. We share your passion for helping the sick and injured get the medications they need. And, we’re willing to take on the paperwork, phone calls and reporting giving you more time to better serve your customers.
For more than 30 years StoneRiver Pharmacy Solutions (formerly Third Party Solutions and WorkingRx) has been the leading provider of workers’ compensation prescription claims management services. We have become a trusted partner to more than 60,000 independent and chain pharmacies nationwide. Powered by our automated, accountable, action-driven technology, which guarantees payment, eliminates bad debt and short pays and improves cash flow in real-time – every time. Your benefits include:
- Guaranteed payment
- Full indemnity where labor and risk is transferred to StoneRiver Pharmacy Solutions
- Increased revenue and profits
- Online adjudication of claims
- No card required
- No out-of-pocket costs for customers
- Acceptance of most employer plans
- Customer care center – 7 days a week
How It Works
The benefits are significant, but the process is easy. You input only minimal information -- patient name, social security number, phone number, employer name and phone number, date of birth and date of injury. And, to make it even more effortless, we’ll even provide forms to collect the proper information. It’s really that simple. The bottom line is your bottom line. StoneRiver Pharmacy Solutions helps you build your business by containing administrative costs, increasing revenue and therefore profits; making happy customers. Happy customers return for other non-occupational prescriptions and become loyal patrons.
To learn more about how StoneRiver Pharmacy Solutions can help you spend more time with customers – call 800.541.5234 or email connect@stoneriver.com.
Your Complete Solution for Workers’ Compensation Prescription Processing.
StoneRiver Pharmacy Solutions – Employers & Payors
Helping employers and payors care for injured employees while managing and reducing pharmacy-related cost is more than our mission. It is a commitment we live daily by delivering our industry-leading solution in workers' compensation pharmacy care management.
We Ask. We Listen. We Carefully Consider. We Deliver!
Despite participation in workers’ compensation prescription programs, many employers and payors fail to achieve anticipated cost savings. Injured workers routinely don’t know or fail to identify the pharmacy program through which to process their workers’ compensation prescriptions; therefore, the pharmacy uses a default billing service. Until now default billing services have been unable to apply financial or clinical controls to these prescriptions. Without these controls prescriptions are processed out-of-network and higher priced medications or medications unrelated to the patient’s injury are dispensed.
StoneRiver Pharmacy Solutions, utilizing advanced proprietary technology, can help payors gain control of out-of-network prescriptions. Using our Network Program enables application of financial and clinical controls to any of the prescriptions presented by our more than 60,000 network pharmacy locations, even when the patient fails to provide program information.
Integrated Technology
Working in cooperation with employers, payors or the payor’s selected PBM, we can receive eligibility and compensability information directly. If direct connectivity is not possible, we have the ability to send a prescription to the preferred pharmacy program’s adjudication platform in real-time when the employer is accurately identified by the transmitting pharmacy. This real-time transmission occurs while the pharmacy is still processing the prescription and once information is received from the adjudication platform, the pharmacy is notified of any financial and / or clinical edits preventing the patient from receiving unauthorized medications. The ability to apply clinical and financial edits, decrease pharmacy costs and to further save costs through gained efficiencies, StoneRiver Pharmacy Solutions can present invoices and receive payments sent electronically. Your benefits include:
- Gain control
- Apply financial control to prescriptions which have historically been out-of-network
- Apply clinical edits to ensure medications are appropriate to the patient’s injury
- Enforce customized formulary
- Apply client specific clinical edits
Decrease Overall Costs
- Through the provision of eligibility and compensability and an agreement for prompt payment, payors can receive discounts off of invoiced amounts
- Eligibility file reduces call center verification and payment status inquiries
- Reduces the volume of non-compensable claims processing
- Electronic billing reduces paper processing costs, bill through rates and reducing duplicate billing activity