Improving drug adherence

Comprehensive clinical solutions help you promote appropriate medication use by engaging employees. Florida Blue + Prime’s clinical programs support adherence and help eliminate gaps in care. And by getting your employees the medication they need, when they need it, our solutions help improve employee safety, decrease waste and connect the employee experience from beginning to end.

GUIDEDHEALTH®

Better medication management decisions

GuidedHealth helps your employees and their doctors make better decisions when it comes to managing their medications, looking at integrated pharmacy and medical claims to address overuse and underuse opportunities, as well as medication safety. These programs provide actionable, clinical intelligence to providers, employees and plans to improve care, costs and outcomes. 1

PA NOTIFY

Increased efficiency and a better prior authorization experience

PA Notify is a proactive notification that alerts prescribers of an expiring drug approval, helping ensure your employees get the medicine they need with no gaps in care. PA Notify helps improve employee satisfaction, reduce appeals and grievances and enhance efficiency for providers.

SMARTRENEW™

Improved experience, significant savings potential

SmartRenew proactively identifies and renews eligible drug approvals (like prior authorizations, formulary and quantity limit exceptions) for employees before those approvals expire. This solution notifies employees of their continued access to their drug with no action needed from them. It also provides savings opportunities for employer groups by reducing clinical review costs.

Florida Blue contracts with Prime Therapeutics, LLC to provide pharmacy benefit management and home delivery pharmacy services.

Health insurance is offered by Blue Cross and Blue Shield of Florida, Inc., DBA Florida Blue.

1 Prime internal data – PDM web ASO BoB Nov ’20 to Oct ’21. Actual savings varies based on programs implemented. Participation in specialty programs may lower realized savings due to high medication cost