The standalone Pharmacy Benefits Management (PBM) solution used by GlobeMed Syria is a core set of tools designed to manage the cost and use of prescription drugs,
The PBM solution uses a core set of tools, built with a state-of-the-art engine, to help control both acute and chronic prescriptions based on the insured member's medical condition and history, evaluate the medical necessity of the prescribed medications, and easily administer the formularies put in place under the supervision of an expert medical committee.
Finally, the e-prescribing and e-dispensing functions come to complete the entire digital process, by allowing physicians to fill out their prescriptions on the system and permitting pharmacies to access these prescriptions online, thus serving the members in an efficient, quick manner.
The features offered by GlobeMed's PBM solution help stakeholders get all the needed information concerning prescription medicine coverage, including the different formulary alternatives, in order to select the appropriate medication that would improve the quality of care provided to the patient, and contain costs and expenses related to pharmacy claims.
Members’ data may be uploaded onto the PBM system through GlobeMed’s members’ administration web portals, thus allowing GlobeMed to manage your pharmacy programs from its own database; data can also be retrieved through online integration with your system, thus eliminating the need to host any members’ information on the GlobeMed database for managing your pharmacy transactions.
Formularies are defined as the lists of prescription medications approved for cover by their respective pharmacy benefits management programs. Under the GlobeMed PBM solution, formularies are reviewed by a committee of medical and pharmaceutical experts, and are adapted to the needs of every risk carrier and each of its client policyholders. The various formularies and protocols, put in place for the different programs served, identify the coverage policy concerning specific pharmaceutical ingredients, establish correspondences between branded and generic medications, and manage the allowed quantities for each product in the respective formulary.
Errors resulting from illegible prescriptions can be hurtful to both you and your members. Today, the conventionally written prescriptions procedure – usually a modality for fraud and abuse – is being revolutionized by the digital world. The treating physician can now submit prescriptions electronically on GlobeMed's PBM system, where they are reviewed in real time, reducing the margin for medication incompatibilities, errors and abuse, and thus enhancing the quality of care directly from the source.
E-Dispensing and Claims Processing
Prescriptions, whether electronic or handwritten, are processed and dispensed by the pharmacies adhering to the GlobeMed network on a real time basis. Through their web-enabled portal connecting them to the PBM system, these pharmacies can verify members’ eligibility, check for replies on requested approvals, and process pharmacy transactions online, ensuring a quick and efficient service to your insured members.
Expert System/Decision Support System
The advanced Expert System, which is built on First Databank (FDB) database, available in GlobeMed PBM solution provides both prescribers and pharmacy service providers with all the elements needed to support the decision-making process. Seamlessly built-in to the e-prescribing and e-dispensing modules, GlobeMed’s Expert System offers a clinical index with more than 3,000 ingredients, automated clinical support for indications and contraindications, generic substitution capabilities, duplication and over prescription alerts, and a drug interactions database.
Drug Disease Contraindication
Dose Range Check
Drug Pregnancy and Breastfeeding Alert
Drug Allergy and Cross Allergy
Drug Age compatibility
Drug Gender compatibility
Drug Renal Alerts
Chronic conditions can be a hassle to the patient and a source of unnecessary expenses for the insurer. With this in mind, GlobeMed conceived the chronic program that allows patients to integrate their chronic conditions and related treatment plans into the PBM database. This program helps preview and audit chronic treatments, and post them, as monthly electronic prescriptions, on the system of a pharmacy selected by the patient or to the entire pharmacy network.
Direct Electronic Settlement
After proper arrangements with local bank(s), the GlobeMed PBM system may, as soon as a claim is approved, instantly trigger an electronic bank transfer from your account to the pharmacy’s account. Should it serve local compliance requirements, or additional discount incentives, the direct electronic settlement feature takes fast-track settlement to pharmacies to the next level.
Our solutions include a variety of reports to help you monitor and follow up every step of the process, by viewing paid and outstanding pharmacy invoices, savings generated on incurred pharmacy claims, and many other detailed reports that support critical program monitoring.