Capital Rx
Capital Rx
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AH045 || Pharmacy Benefits 101: Formularies & Formulary Management, with Nisha Bhide, PharmD
In this episode of the Astonishing Healthcare podcast (www.cap-rx.com/podcast) , Nisha Bhide, PharmD, joins Justin Venneri in the studio to discuss an integral aspect of pharmacy benefit management (PBM) - the formulary. They explore everything from what a formulary is to how they are created and P&T committees, why and how often they change, the role JUDI® (www.cap-rx.com/solutions/pba-judi) plays in managing a formulary efficiently, and the difference between open and closed formularies.*
Nisha also dives into how specialty drugs fit into the equation, utilization management tools like prior authorization (PA), the role of formularies in helping manage low-cost generic or high-cost brand lists, and more!
Related Content
• Pharmacy Benefits 101: What is a Formulary? (www.cap-rx.com/insights/pharmacy-benefits-101-what-is-a-formulary)
• Replay - Cracking the Code: Unraveling Specialty Drug Costs & PBM Profits (www.cap-rx.com/insights/replay-cracking-the-code-unraveling-specialty-drug-costs-pbm-profits)
• Capital Rx Receives a US Utility Patent Covering its Enterprise Health Platform - JUDI® (www.cap-rx.com/insights/capital-rx-receives-a-us-utility-patent-covering-its-enterprise-health-platform---judi-r)
• AH035 - Pharmacy Benefits 101: Clinical Programs, with Bonnie Hui-Callahan, PharmD (www.cap-rx.com/insights/ah035---pharmacy-benefits-101-clinical-programs-with-bonnie-hui-callahan-pharmd)
For more information about Capital Rx and this episode, please visit Capital Rx Insights (www.cap-rx.com/insights) .
*If you'd like to dive into the details of a formulary, check out Capital Rx's Freedom (Open) Formulary Lookup (caprx.adaptiverx.com/webSearch/index?key=8F02B26A288102C27BAC82D14C006C6FC54D480F80409B68F7175D0DC1577226) or Capital Rx’s Liberty (Closed) Formulary. (caprx.adaptiverx.com/webSearch/index?key=8F02B26A288102C27BAC82D14C006C6FC54D480F80409B6860374AA7ED985B45)
Переглядів: 49

Відео

AH044 - Searching for Answers: Understanding Transparency, Alignment, and Incentives in Healthcar...
Переглядів 1716 годин тому
On Episode 44 of the Astonishing Healthcare podcast (www.cap-rx.com/podcast) , Andrew Gordon, LSW, joins host Justin Venneri for a discussion about the extensive primary research he's conducting on transparency and incentives in the U.S. Healthcare system. Gordon, who recently interviewed Capital Rx co-founder and CEO AJ Loiacono (www.linkedin.com/posts/andrewgordon182_healthcare-transparency-p...
AH043 - Pharmacy Benefits 101: DMP & MTM, Explained, with Nash Albadarin, PharmD
Переглядів 3016 годин тому
This episode of the Astonishing Healthcare podcast (www.cap-rx.com/podcast) covers the ins and outs of two programs in the government sector - i.e., Medicare and Medicaid - and how modern technology - JUDI® (www.cap-rx.com/solutions/pba-judi) - allows for more agility and flexibility in delivering care to Part D plan members and meeting CMS requirements. Capital Rx's Nash Albadarin, PharmD, exp...
AH042 - Pharmacy Benefits 101: The Network, with Kasi Ortiz
Переглядів 716 годин тому
In this episode of the Astonishing Healthcare podcast (www.cap-rx.com/podcast) , Capital Rx's Vice President of Provider Relations, Kasi Ortiz, joins Justin Venneri in the studio to discuss the network component of pharmacy benefits. They discuss how modern technology - JUDI® (www.cap-rx.com/solutions/pba-judi) - allows for flexibility and customization of the network to meet plan sponsors' var...
AH041 - ERISA Litigation Outlook and Meeting CAA Requirements: What Can Plan Fiduciaries Do?
Переглядів 1516 годин тому
On this episode of the Astonishing Healthcare podcast (www.cap-rx.com/podcast) , three experts weigh in on rising litigation against employers and pharmacy benefit managers (PBMs) and what employers sponsoring ERISA-covered health and welfare plans can do to show they are making an effort to establish processes and assess how "reasonable" the fees they pay are. Chris Deacon, Founder of VerSan C...
Smart Tags and Overrides || Webinar Clips
Переглядів 13Місяць тому
One of JUDI's most exciting features is "Smart Tags and Overrides." As Jillian Lonson, PMP® (Senior Director, Benefits Administration & Operations at Capital Rx) explained during our webinar, "The Future of Pharmacy Claims Processing: A Deep Dive into a Modern Adjudication System," this feature enables Capital Rx to configure custom rule sets without programming required to dictate any outcome,...
Configuring a Medicare Benefit in JUDI® || Webinar Clips
Переглядів 94Місяць тому
Part of what makes JUDI® such an impressive and flexible platform is its ability to streamline complex processes and create efficiencies that don't currently exist in legacy systems. For example, as Jeff Brocker (Senior Product Manager) explained during our webinar, "The Future of Pharmacy Claims Processing: A Deep Dive into a Modern Adjudication System," configuring a Medicare benefit in JUDI ...
Pre-Configure Medicare Plan Benefits - JUDI® vs Legacy Systems || Webinar Clips
Переглядів 28Місяць тому
Capital Rx's Jillian Lonson, PMP® (Senior Director, Benefits Administration & Operations) is no stranger to pharmacy claims processing platforms. She has worked both in legacy systems and in JUDI®, and as she outlined during our webinar, "The Future of Pharmacy Claims Processing: A Deep Dive into a Modern Adjudication System," the difference could not be starker. As an example of this, she expl...
JUDI® and the Inflation Reduction Act || Webinar Clips
Переглядів 25Місяць тому
How was JUDI® able to be production-ready less than a month after the release of the new Inflation Reduction Act guidance? During our webinar, "The Future of Pharmacy Claims Processing: A Deep Dive into a Modern Adjudication System," Jeff Brockner (Senior Product Manager) dove into the details and explained how JUDI's interoperability and flexibility makes it easy to adjust for new regulatory r...
JUDI®'s Modules & Functionality || Webinar Clips
Переглядів 26Місяць тому
During our webinar, "The Future of Pharmacy Claims Processing: A Deep Dive into a Modern Adjudication System," Jeff Brockner (Senior Manager, Product) discussed just how interoperable JUDI is. Specificially, while claims processing is JUDI's core capability (after all, JUDI is short for adjuducation), the platform has numerous others. Watch this clip to learn what other functionality and integr...
JUDI's "Reasons for Adjudication" Feature || Webinar Clips
Переглядів 23Місяць тому
During our webinar, "The Future of Pharmacy Claims Processing: A Deep Dive into a Modern Adjudication System," Jillian Lonson, PMP® (Senior Director, Benefits Administration & Operations at Capital Rx) discussed one of her favorite JUDI® features: Reasons for Adjudication! This powerful feature provides deeper insight into how a pharmacy claim is adjudicated, bringing clarity to an increasingly...
JUDI®'s Bulk Action Feature || Webinar Clips
Переглядів 36Місяць тому
During our webinar, "The Future of Pharmacy Claims Processing: A Deep Dive into a Modern Adjudication System," Jillian Lonson, PMP® (Senior Director, Benefit Administration Operations) discussed JUDI®'s Bulk Actions feature. This feature allows a user to load everything from custom rule sets to #clinicalrules and #formulary elections in an incredibly efficient, streamlined manner. This is what ...
AH040 - Celebrating Women Pharmacist Day 2024
Переглядів 616 годин тому
On this episode of the Astonishing Healthcare podcast (www.cap-rx.com/podcast) , four women pharmacists across Capital Rx's teams join host Justin Venneri to celebrate #WPD2024! Amy Stockton, PharmD (our guest for Episode 6); Symara Schmidt, PharmD, BCGP; Lauren Carroll, PharmD, BCACP; and Marissa Miller, PharmD, discuss the significance of Women Pharmacist Day and highlight the progress women ...
Capital Rx's Experience Working With CMS & Medicare || M3P Webinar Clip
Переглядів 30Місяць тому
In addition to the technological capabilities underpinning our Medicare Prescription Payment Plan (M3P) solution, Capital Rx brings another important factor to the table: experience working with Centers for Medicare and Medicaid Services (CMS). We are prepared to be as active a partner as Medicare Part D plan sponsors need to ensure member satisfaction and program compliance. Watch this clip fr...
Member View & Payment Options within JUDI® || M3P Webinar Clip
Переглядів 18Місяць тому
As you might imagine, the Medicare Prescription Payment Plan (M3P) is a big shakeup for pharmacies, PBMs, and plan sponsors. However, because our enterprise health platform, JUDI®, is so flexible and scalable, Capital Rx is able to create and offer a standalone, turnkey, end-to-end M3P solution for health plans, payers, and PBMs that offer Medicare Part D. In this clip, Capital Rx's co-founder ...
The Importance of M3P Education || M3P Webinar Clip
Переглядів 21Місяць тому
The Importance of M3P Education || M3P Webinar Clip
Demonstrating the Payment Dashboard in JUDI || M3P Webinar Clip
Переглядів 18Місяць тому
Demonstrating the Payment Dashboard in JUDI || M3P Webinar Clip
AH039 - Transition Benefits and the Relationship Between Communications and Product Management
Переглядів 616 годин тому
AH039 - Transition Benefits and the Relationship Between Communications and Product Management
AH038 - Navigating Flu Season! A Quick Update on Vaccines and Such, with Libbi Green, PharmD
Переглядів 4116 годин тому
AH038 - Navigating Flu Season! A Quick Update on Vaccines and Such, with Libbi Green, PharmD
How PBMs' Role Evolved Over the Years || Webinar Clip
Переглядів 32Місяць тому
How PBMs' Role Evolved Over the Years || Webinar Clip
What Is in the FTC Interim Staff Report? || Webinar Clips
Переглядів 27Місяць тому
What Is in the FTC Interim Staff Report? || Webinar Clips
The Problem of Contractual Entanglement || Webinar Clip
Переглядів 9Місяць тому
The Problem of Contractual Entanglement || Webinar Clip
An Overview of Our Never Move Again™ Solution || Webinar Clips
Переглядів 14Місяць тому
An Overview of Our Never Move Again™ Solution || Webinar Clips
Never Move Again™ Pillar 1 - CAA Compliance || Webinar Clips
Переглядів 9Місяць тому
Never Move Again™ Pillar 1 - CAA Compliance || Webinar Clips
Never Move Again™ Pillar 2 - Data Storage || Webinar Clips
Переглядів 25Місяць тому
Never Move Again™ Pillar 2 - Data Storage || Webinar Clips
Never Move Again™ Pillar 3 - Modular Services
Переглядів 12Місяць тому
Never Move Again™ Pillar 3 - Modular Services
Never Move Again™ Pillar 4 - Agnostic Network
Переглядів 16Місяць тому
Never Move Again™ Pillar 4 - Agnostic Network
Never Move Again™ Pillar 5 - Financial Alignment
Переглядів 27Місяць тому
Never Move Again™ Pillar 5 - Financial Alignment
Never Move Again™ Pillar 6 - Customer Service
Переглядів 20Місяць тому
Never Move Again™ Pillar 6 - Customer Service
Build a Lasting Pharmacy Benefit Strategy with Never Move Again™ || Webinar Replay
Переглядів 59Місяць тому
Build a Lasting Pharmacy Benefit Strategy with Never Move Again™ || Webinar Replay

КОМЕНТАРІ

  • @Marketerpartha21
    @Marketerpartha21 Місяць тому

    Hey there, Love how you enjoy your Business. I view almost all of your UA-cam Videos on Capital Rx. All of the widest collections of Pharmacy. Even one of my friends has made his UA-cam Channel by following your UA-cam post! Your effort reflects how passionate you are. In March 2020 to Post 64 public video within 4 years is really appreciable. I found your website too while surfing your UA-cam Channel which is also on the Pharmacy niche. Great! I am a webmaster and also love to do blogging and youtubing like you. I am the leader of the largest active blogging community in my country. Do you know how good your prospects are? The selling value of websites built on the new niche Pharmacy is very high. The pharmacy is one of the top five most viewed product categories on Social media. But as a Social media expert am a little bit disheartened after watching your UA-cam view count for the last 4 consecutive Years and the visitors of your website as well. However, you are giving effort. And hard work always pays off. To get that you need to work a bit more moderately. If you agree I can share with you some opinions based on my social media and blogging experience. I don’t want to Capital Rx you and interface with your work. Feel free to let me know If you are Interested. I’ll be there for you. Partha Das, Webmaster, Blogger & Social media expert

  • @expert9477
    @expert9477 10 місяців тому

    ua-cam.com/video/oCzQrljuEZI/v-deo.html

  • @thomasfoolery8408
    @thomasfoolery8408 Рік тому

    Unrelated - we appreciate your public address regarding the intoxicated employee who voice some prejudicial nonsense on the New Jersey transit - thank you for being human beings and doing the right thing. I hope others can learn from your example if aplicable . GOOD MOVE - TF

  • @MPS72192
    @MPS72192 Рік тому

    I been binge watching Capital Rx vidoes this past week. This looks like an awesome start up, I would love to work for you guys if you ever had an opportunity!

  • @mixitup01
    @mixitup01 Рік тому

    "Choosing consolidation over innovation"...so true! Sure, mergers might make good business sense but they rarely benefit the end-user aka clients. Innovation is needed to make all these newly acquired platforms through acquisitions work seamlessly together. Transparency is key for success (AWP, NADAC, Rebates; etc.)

  • @masakanasugi
    @masakanasugi Рік тому

    Lets go Dr. Gibbs!!!🎉

  • @ermonski
    @ermonski 3 роки тому

    I hope Joey Styles gets featured as well

  • @chicagoland1983
    @chicagoland1983 3 роки тому

    LOVE LOVE LOVE!!!! Sooooo good! Thank you, CapRx for celebrating EVERYONE! Happy Pride!!!