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POC Network Technologies represents a new model for payors (health plans, prescription benefit managers, self-insured parties, etc.) to manage and distribute risk related to the administration of drug benefits (both vaccines and oral solids) at the point of care.
20/20 foresight.eDispense marks a significant step forward in the evolution of claims management. Traditionally, health benefits have been retrospectively managed. This backwards orientation—and the risks it presents to payors—is arguably the greatest shortcoming in medical benefits administration today.
In an effort to contain costs for high-cost medical treatment (e.g. oncology, rheumatology), many payors are seeking ways to gain control over claims much earlier in the process—at the point of care. Many realize that they would be able to achieve greater control in claims management if they were able to process a medical benefit as a pharmacy benefit.
PNT's eDispense gives that control to prescription benefits managers and others. By taking advantage of the connectivity that the eDispense portal provides, payors enjoy expansive real-time pre-editing ability in administering benefits at the point of care. This allows payors and physicians to pre-authorize the transaction and to determine beforehand in real-time the patient's financial responsibility and other reimbursement details. This in turn allows both payors and physicians to avert financial risk and make more informed benefits recommendations to patients.
New service offerings. The eDispense portal provides a solution to payors looking to create exciting new service offerings previously not available to them.
Attract more physicians. eDispense also provides payors with the ability to connect to large groups of physicians using PNT Provider Networks. When physicians participate in these unique networks, payors have an unprecedented opportunity to access and attract new doctors and drive business.
Electronic processing. eDispense boasts a well-established back-office utility for electronic invoice and payment processing to providers. Not traditionally afforded to payors, this unique utility eliminates paperwork and administrative costs.
To learn more about PNT's solutions for payors, click here or call (714) 727-1900.
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