Who we work with · Health plans and PBMs
A handful of refills can decide a Star Rating. We make those calls.
The adherence measures close on December 31 and the pool of members you can still save gets smaller every week. Our callers reach those members, find out what stopped the refill, and get it filled, under a BAA and inside HIPAA's refill reminder exception.
- Program
- Adherence gap call
- Member
- Diabetes measure · 2 fills short
- Barrier
- Ran out while traveling
- Resolved
- Refill placed for pickup today
- Refill
- Filled
- Measure
- Gap closed before December 31
- Length
- 4m 05s
The calendar
The measures run on the calendar year and so does our schedule.
PDC measures reset in January and close in December. We work your gap list in measure order, starting with the members who can still be saved. We keep working it until the year closes.
December 31 is the deadline.
Every week before it, there are fewer members who can still reach the measure. The earlier the list reaches us, the more of them we can still save.
A single measure can be worth millions.
The gap between one Star Rating and the next is decided by a small number of refills. Those are the calls we make.
Med sync keeps them from slipping again.
Ongoing med sync and refill reminder calls keep members from falling below the measure in the first place.
Programs
Pharmacy adherence outreach, program by program.
Adherence gap calling
We call the patients who have fallen behind, work through what stopped them, and get the refill placed before the measure closes.
Priced
A dedicated agent on retainer, a per-store fee, or a fixed-scope program, depending on who's buying.
Med sync and refill reminders
Ongoing calls that enroll patients in synchronized monthly fills and confirm each refill before it lapses.
Priced
Recurring program. Scoped in your proposal.
Specialty persistence and January reset
Scheduled persistence calls for specialty patients, plus a January check on coverage and prior authorizations before an insurance reset interrupts therapy.
Priced
Per enrolled patient for persistence. Fixed scope for the January campaign.
Compliance
Built for a plan's compliance review.
Your members' data, our callers, and the rules that keep the two apart.
- Refill reminder exceptionRefill calls stay inside HIPAA's refill reminder exception.
- HIPAA · BAAWe sign the BAA before we see a single record.
- Controlled substancesControlled substances are excluded from every program.
- Flat fees · Anti-kickbackWe are paid for the work, never for the order.
Send us your gap list size.
Tell us how many members are below the measure and we'll reply with a priced program.