Rx Prescriber Intervention Programs

  1. Formulary Intervention Program
    Interchanges high cost medications that have lower cost therapeutic alternatives on the MediGold formulary. We send you a fax and ask that you review, sign and return to us. 
  2. Stars Adherence Program
    You may receive a fax from us or one of our partners, working on our behalf.
  • Initiate statin therapy for diabetic members.
  • Initiate statin therapy for cardiovascular disease.
  • Initiate a bone density scan for female members with a fracture.
  • Initiate DMARDs in patients diagnosed with rheumatoid arthritis.
  • Keep medication adherence over 80 percent for members taking statins, diabetes medications and blood pressure medications.

      Programs assist prescribers by:

1.    Identifying members/patients benefiting from the intervention programs.

2.    Reaching out to members regarding approved therapy changes or newly prescribed medications.

3.    Sending new prescriptions to a member’s pharmacy.


     We manage all steps in the program, except #2 below:

1.    Send member-specific fax to the prescriber with recommendations.

2.    Prescriber faxes back the approved therapy.

3.    Call member to inform and educate.

4.    New prescription is sent to pharmacy of choice.

 

      If you have questions regarding our Prescriber Intervention Programs, please call: 800-319-4684.

 

Updated 10/2018