Healthcare Solutions

Adjuster can view all prescription data and savings reports online. With 1.1 Cypress Care PCCS If it's a first fill and Employer/Payor is enrolled in CCRX First Fill, Payor gives Worker CCRX info. PCCS Cypress Care SEQUOIA Patient Care Coordinat 1.1 PCCS receive Worker's Permanent Eligibility from Payor. 1.2 PCC enrolls Worker into CCRX,calls Worker and his/her pharmacy and mails CCRX Card to Worker. Adjuster's Life With Cypress Care 1.3 Worker goes to Doctor to get prescription. 1.5 PAID 1.4 Worker gets script filled at pharmacy. DENIED ALERT 1.2 a. If it's a CCRX First Fill, Pharmacist Dynamically EnrollsTM Worker into CCRX online. b. If Worker is already enrolled, Pharmacist processes script through Sequoia online. Sequoia alerts PCC that bill is a duplicate and sends message back to pharmacist. Pharmacist connects to Sequoia alerts pharmacists, PCC and adjuster to resolve before dispensing.DUR Edits capture drug to drug interactions, duplicate therapies, unauthorized Drs., early Sequoia requires pharmacist to dispense generic when available. 92% brand to generic conversion! Sequoia which denies script as 1.5 Sequoia immediately alerts pharmacy online that prescription and payment are authorized. non-compensable to injury. PCC alerts Adjuster and 80%+ Industry Leading Utilization Rates requests Prior Authorization. refills and allows for true customization at patient level. 14% compliance improvement vs. industry average. 1.3 1.4 Injured worker visits three Worker goes to pharmacist to try to get prescription filled. Pharmacist/third 5 party biller sends a duplicate bill. Generic medication An injured worker requires prescription medication to treat work-related injury. Friend tells injured worker that he can get all the 2 drugs he wants and sends him to his "friendly" doctor who writes him a script for Viagra. separate doctors. Each prescribe 3 different drugs that may have 1 4 available for injured worker's meds. tragic interactions. Pharmacist dispenses Without controls, Without controls, 4 Overworked adjuster mistakenly repays the bill or re-runs through Bill Review, paying pharmacist dispenses higher cost brand Rx. unrelated medications pharmacists dispense drugs. Injured Worker has choice. Either he: e.g., Viagra Potential harm to Worker. 1.1 Pays full retail price and sends bill for reimbursement to Employer 1.1 Unnecessary $$ spent Third Party Bill created Unnecessary $$ spent Third Party Bill created Unnecessary $$ spent Third Party Bill created additional fees. OR 1.2 1.2 He fills out necessary forms to allow for Third Party Biller to cover cost. Third Party Biller charges above premium rates and sends Paper Bill to Employer. WITHOUT Cypress Care Cypress Care Paper Bill Eliminator 3R0 PARTY BILLER An Adjuster's Life Without Cypress Care