
Understanding your unique needs and building solutions to improve members' health while controlling costs is our top priority. Prime provides a menu of solutions and takes a consultative approach with clients to ensure their pharmacy needs are meet. As our client, you have access to many innovative PBM products and services including:
Triessent is Prime’s specialty pharmacy management program. It provides specialty pharmacy solutions that support a superior member experience, while balancing the real-world financial and logistical considerations of members and plan sponsors. Triessent provides three essential services:
Triessent can provide potentially better health outcomes and lower costs across the health care spectrum.
PrimeMail® provides safe, convenient, cost-effective prescription delivery services. Our state-of-the-art facility offers a fully integrated mail service solution backed by an expert pharmacy staff and account support.
PrimeMail Preferred 90 is a benefit plan option available through Prime that provides clients with cost-effective prescription dispensing as employees fill their maintenance medications through PrimeMail.
PrimeImpact® is a suite of programs that impact drug utilization patterns to help ensure members achieve the best health outcomes at the lowest financial cost.
These clinical programs provide various levels of interventionsfrom education programs to benefit driversthat improve the quality of care for members while increasing the value of the pharmacy benefit for payors.
PrimeImpact programs address several key issues in pharmacy benefit management, including:
In support of clinical programs, Prime monitors drug pipeline changes, drug spending and therapeutic opportunities within each PrimeImpact core category and reports these back to our clients through our Prime Drug Insights suite of communications.
With consumerism on the rise, Prime recognizes the importance of providing benefit options, such as consumer-directed health plans (CDHP), that empower members to make more informed choices about their health care.
To successfully manage CDHP benefits, our Integrated Product Solutions (IPS) system facilitates electronic messaging with fiduciaries, handling a combination of account types and integrating with debit card vendors for flexible payment options. IPS stores member benefit and account eligibility information so that at the point of sale members have immediate access to their account funds without the hassle of a separate debit card or paper claims.
To achieve an optimal member experience, Prime's integrated approach to claims management provides real-time eligibility verification and accurate accumulator calculation, virtually eliminating the need for paper claims.
PrimeReporter is Prime's comprehensive reporting solution that offers a broad array of reporting capabilities, including: monthly claims reports, client performance reports, clinical reports, administrative reports and ad hoc custom reports. Reports are available to clients in paper and electronic formats. Prime can customize report packages to meet client's needs. Prime's Account Management team works with clients define the parameters of these reports during the business integration process.
Prime serves over 800,000 Medicare Part D beneficiaries. We have a separate Government Program department specifically dedicated to supporting the Medicare Part D program, which meets the needs of our clients as well as the requirements of the Centers for Medicare and Medicaid Services.
Prime provides participating pharmacies information on plan changes, continuing education opportunities and general claims adjudication issues in addition to online messaging with every adjudicated claim.
Prime at a Glance
PrimeReporter
Benefit Edit Tool
New Benefit Edit Tool
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Pharmacy and Therapeutics Schedule