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State-of-the-Art Technology Services


ProCare Rx’s system is robust and flexible and offers a hybrid PBM/PBA support model. Our product offering is available under a wide range of business models, including Software as a Service (SaaS), Private Label, and Pharmacy Benefit Administration (PBA).


The Pharmacy Claims Processing Master Suite allows you to manage all aspects of your prescription drug program. Our systems are extremely flexible in extracting any data, groupings, categories, etc., from your data and delivers extensive scalability. All reporting is determined by the eligibility hierarchy set up through the implementation process and discussions around eligibility vs. financial reporting. ProCare Rx provides easy-to-use online tools and applications to manage core services, including Claims Review, Patient Management Tools, Plan Edit Functions, and a customized Reports Portal.


We differentiate ourselves by offering our business partners creative technology solutions without the fear of discontinuation of support or unresponsive service. We offer business solutions to maximize our relationships and prove our value through exemplary customer service and clear, accurate reporting. With over 30 years of experience in the healthcare technology industry, ProCare Rx systems are agile, time-tested, and meet all quality and security measures; SOC1 and SOC2 audit certified.


Other Technology Services

  • Technology Services

    • Claims processing and adjudication services powered by a Cloud-Based, state-of-the-art claims processing platform 
    • Real-time accumulator tracking
    • Automated True Out-of-Pocket (TrOOP) balance transfers
    • Coordination of Benefits
    • Eligibility processing
    • Prior Authorization system
    • e.Prescribing
    • e.PA Services
    • Online reporting systems
    • Healthcare analytics platform
    • PDE Management Program
    • CMS Data Management Program
    • Population Health Management platform

  • Technology Support Tools

    • Web-based, online, real-time plan, pharmacy, physician, and member management application for clients 
    • Web-based Member Portal
    • Manufacturer Rebate Management System
    • Web-based Pharmacy Support Center Application 
    • PBM Applications Suite

  • Our Systems Support the Following Plan Types

    • Commercial
    • Self-Insured Employers
    • Medicare Part D
    • Medicare Part C
    • Medicare Part B
    • Workers Comp Plans 
    • Medicaid Programs
    • Government Employees
    • Unions
    • 340B Plans
    • Coupon & COB Programs
    • Patient Assistance Programs
    • Reimbursement HUB Services

  • Website & Mobile Applications

    At ProCare Rx, we develop and implement tailor-made web and mobile applications to provide support and information and to respond and solve member needs and inquiries.


    Among the capabilities we can provide are:


    • Customized Member Portal website
    • Smartphone app for members
    • Seamless integration with clients’ web and mobile platforms

  • Technical Capabilities

    • Network pharmacy locator
    • Formulary lookup
    • Copay lookup
    • Drug monographs
    • Therapeutic alternatives lookup
    • Create and review health-related contacts (pharmacies, physicians) 
    • Review medication history  

    Additional capabilities can be designed and implemented upon request.

State-of-the-Art Technology Services

ProCare Rx’s system is robust and flexible and offers a hybrid PBM/PBA support model. Our product offering is available under a wide range of business models, including Software as a Service (SaaS), Private Label, and Pharmacy Benefit Administration (PBA).


The Pharmacy Claims Processing Master Suite allows you to manage all aspects of your prescription drug program. Our systems are extremely flexible in extracting any data, groupings, categories, etc., from your data and delivers extensive scalability. All reporting is determined by the eligibility hierarchy set up through the implementation process and discussions around eligibility vs. financial reporting. ProCare Rx provides easy-to-use online tools and applications to manage core services, including Claims Review, Patient Management Tools, Plan Edit Functions, and a customized Reports Portal.


We differentiate ourselves by offering our business partners creative technology solutions without the fear of discontinuation of support or unresponsive service. We offer business solutions to maximize our relationships and prove our value through exemplary customer service and clear, accurate reporting. With over 30 years of experience in the healthcare technology industry, ProCare Rx systems are agile, time-tested, and meet all quality and security measures; SOC1 and SOC2 audit certified.

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PBM PRIVATE

LABEL 

Private Label

ProCare Rx has a long history of offering Private Label system services. You can contract for our system only, or bundle different services depending on what programs you (or your clients) want to perform. Our program is scalable; we can do all of the work using your corporate identity, or you can run the areas that you are comfortable with managing. 


We offer and maintain a Delegation of Services document so that everyone has an understanding of who is responsible for what specific service at all times. We can also handle all the billing for you and your clients through our “dual billing” options. At some point in the partnership, you may have the internal resources to take more control. You will always have the option to become your own PBM when you are ready, and we will help you with the transition. 

READ MORE

PBM PRIVATE LABEL 

Private Label

ProCare Rx has a long history of offering Private Label system services. You can contract for our system only, or bundle different services depending on what programs you (or your clients) want to perform. Our program is scalable; we can do all of the work using your corporate identity, or you can run the areas that you are comfortable with managing. 


We offer and maintain a Delegation of Services document so that everyone has an understanding of who is responsible for what specific service at all times. We can also handle all the billing for you and your clients through our “dual billing” options. At some point in the partnership, you may have the internal resources to take more control. You will always have the option to become your own PBM when you are ready, and we will help you with the transition. 

READ MORE