With StreamCare, you can quickly impact your bottom line by capturing more of the profits you deserve for your work.
As an industry partner of PDS, StreamCare helps members bill direct for their worker’s compensation prescriptions and effectively eliminate the costly PBM middleman.
Through StreamCare’s solutions, you will be able to easily process worker’s compensation prescriptions and yield a much higher profit for your pharmacy.
Many independent pharmacists are missing out on the profits they deserve because they’re billing through a typical PBM or processor. As a result, they are subject to that third-party’s rate schedules — allowing them to keep the difference. In many cases, the difference can be significant since many states offer a very generous reimbursement schedule rates for work comp prescriptions.
StreamCare helps you bypass the PBM by billing direct to your state’s workers’ compensation carrier, thereby allowing you get to keep more of your profit.
Increase the Profitability of Your Pharmacy
Consider the potential impact on your profitability. For example, if your current PBM contract is currently at AWP 82% for generic reimbursements, you could be missing out on a significant number of dollars if your state will pay full AWP for the same generic. StreamCare charges a 30% fee for generics and lower for brands from what is collected only. That means a $10 reimbursement could become a $190 reimbursement just from using StreamCare. (StreamCare is not a solution for all states).
It’s important to understand that each state has a reimbursement schedule they are willing to pay for work comp prescriptions, many at full AWP for a generic. Many independent pharmacists never realize that full reimbursement since PBMs may take up to 95% of the claim.
Benefits of Working with StreamCare
- Work comp carrier will not pay out any more money by using the StreamCare method.
- StreamCare charges 30% of what is collected for generic claims and even less for brand name claims. They only get paid if you get paid.
- StreamCare takes on the hard work of billing direct through the backend. A pharmacy billing to StreamCare is similar to billing a regular claim except you must provide extra information (i.e. date of injury, employer information) since it is due to an injury.
- Streamcare, after receiving the claim, will manually bill the proper insurer.
Start getting the maximum reimbursement possible by billing direct for your work compensation patients.