Prescription Benefit Management
Prescription Drug Card Program — Administration & Reporting

Reporting Capabilities

Universal Rx's provides management reporting packages for all of our Clients; Employers, TPAs, Brokers or Consultants. There are three main management reporting packages provided by Universal Rx.

Management Reporting Packages

Executive Quarterly Reporting Package

The Universal Rx Executive Quarterly Reporting Package is provided to all Employer Clients, TPAs and Broker/Consultants. Semi-annual and annual reviews are performed on-site to review the data in detail.

Executive Monthly Reporting Package

The Universal Rx Executive Monthly Reporting Package provides a snapshot of summary data on a monthly basis.

Claims Utilization Reporting Package

The Universal Rx Claims Utilization Reporting Package is delivered to the client every two weeks and included with the billing. This package provides information needed to determine claims trends.

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Reporting Access

Client Access to Secure Database

Universal Rx offers an extensive data warehouse of management reports along with PBM tools to provide employer clients information on their plan’s performance.

Management reports offer both detail and summary information specific to the utilization and trend performance for the plan. A small sample of such information available includes: total claims, total incurred dollars, total plan paid dollars, total co-payment, total brands purchased, total generics purchased, total generic potential, total generic potential savings, top utilized drugs, and top utilizing members.

All clients can access and run all management reports at no additional cost.

Management Report Examples

Below are just a few samples of the approximately 60 different online reports available at no cost to our clients.

1. Active Member Listings:
   This provides management a list of all individuals currently active with the Universal Rx prescription benefit program. This affords management the opportunity to review eligibility for accuracy. This report is generated by Universal Rx and provided once a month automatically.
2. Members Claim Summary:
   Provides management a snapshot of each plan member who had a claim process during a specified time frame, the number of claims, the amount the plan paid for these claims and the co-payment (amount plan member paid).
3. Members Ranked by Rx, Amount Paid, or Co-payment:
   Ranks members by number of claims purchased, total plan paid amount, or total co-payment amount for a specified time frame so to easily identify those members who may benefit from individual case management.
4. Claim Activity with Tier by Member:
   Lists all claims processed for a specific time frame along with the member who purchased it, what group number they are in, the date in which it was purchased, the tier category in which the drug is classified, the gross amount, co-payment and plan paid amount. This report is utilized during the Preferred Rx Program to identify the top utilized tier 3 medications.
5. Claims Itemizations Reports:
   Provides management with a list of all claims activity for a specified time frame for an individual plan member. This is useful if a plan needs or wants to monitor if a plan member has met a deductible or is reaching a maximum amount allowed limit.
6. Generic Utilization Report:
   Provides management with a snapshot of generics purchased and the savings to the plan due to these generics being purchased instead of the alternative brand. This report also shows generic potential; meaning, the number of generics that could have been purchased but a brand was purchased instead. Additionally, it shows the potential plan savings had the generics been purchased instead of the brand.
7. Claims Cost Summary by Month:
   Shows for a specified time frame the total number of paid claims, number of active members, total members, total employees, total claim amount, total plan paid amount, total co-payment, plan paid amount per claims, number of Rx’s per member per month, number of Rx’s per employee per month and total dollars per employee per month.

Custom Reports

In addition to the reports listed above, Universal Rx has a Reporting Team who specializes in developing reports when data is needed. This team develops any needed reports and provides them to the client at no additional cost.

A tremendous amount of effort is put into the development and sharing of data with clients, vendors, consultants and third parties as we understand how important it is in evaluating the performance of the plan. This allows the proper modifications to the plan design to ensure plan goals are met.

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HIPAA Compliance

Universal Rx has long made it a practice to safeguard the confidentiality of the personal health information of its clients’ members. The Health Insurance Portability and Accountability Act (HIPAA) of 1996 has advanced this effort by implementing privacy standards throughout the healthcare industry.

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Prescription Drug
Card Program

• Plan Design
• Customized Plan Solutions
• Prescription Fulfillment
  • Retail Pharmacy Network
  • Mail Order Pharmacy Services
  • Int'l Mail Order Pharmacy Services
• Implementation Services
  • Enrollment Support
  • Benefit Communication
• On-Going Plan Management
  • Formulary Management
  • Pharmacy Data Management
  • Drug Utilization Review
  • Disease Risk Stratification
• Administration & Reporting
  • Administrative Services
  • Reporting Access & Capabilities
• Account Management
  • Universal Rx Pledge
  • Team Approach
  • Performance Guarantees