Pharmacy Benefit Management Program
Prime Health Services is pleased to make available the Prime
Health Services Pharmacy Benefit Management (PBM) Program, PrimeRx.
PrimeRx is tailor‐made to address the unique needs of the workers'
compensation injured worker, and seamlessly offers a solution to
the challenge of out‐of‐network pharmacy bills and third‐party
Prime Health has teamed with Progressive Medical Inc., one of
the largest and well known PBMs in the workers' compensation
industry to provide an one‐of‐a‐kind, revolutionary pharmacy
program. Our exclusive partnership with Progressive Medical
provides the following:
Environment: PrimeRx allows for seamless
identification of injured workers at the pharmacy in a cardless
environment. In the event the card is not available, our program
will ensure a discount on the bill. Cards are supplied to the
injured worker post first fill.
- First Fill
Discounts: PrimeRx offers a proprietary
ability to apply discounts below AWP on the first fill by forcing
the transaction in‐network versus being processed by a third party
- Eligible Employee
Discounts: PrimeRx offers some of the most
competitive and deepest discounts on all in‐network injured
- Non‐eligible Employee
Discounts: PrimeRx allows for application of
discounts below State Fee Schedule, to non‐eligible injured worker
pharmacy claims. Discounts are provided via the Prime Health
Services EDI bridge. This guarantees that virtually every bill will
have a savings and you'll never have to deal with third‐party
- Nationwide Pharmacy
Access: PrimeRx gives access to 64,000
pharmacies nationwide including Target, Wal‐Mart, Kroger, K‐Mart,
CVS, Walgreens and Safeway (just to name a few).
Customization: PrimeRx offers complete
customization of the formulary to meet the unique needs of the
client by utilizing medication plans. Specific Injured Worker
Notations: PrimeRx offers the ability to flag individual injured
workers to require a pre‐authorization of EVERY prescription filled
PrimeRx is the only program of its kind in the workers'
compensation industry. This program stands alone in its ability to
offer a discount on every pharmacy bill in a seamless, real‐time,