Rx Review Program

Introduction

The Rx Review Program assists members in managing their medications in an effort to avoid serious health risks and potential medication errors. The program provides many benefits to qualified members, such as:

  • Medication recommendations;
  • Helps members understand what happens if you miss a dose or are currently taking the wrong dose;
  • Identified ways to reduce side effects of your medications;
  • Assists you in forming a medication routine;
  • Gives suggestions for vitamins and alternative therapies that may help contribute to your overall health;
  • Gives recommendations of clinical tests you should be receiving regularly;
  • Help with how and when to take your medications;
  • Creates an action plan for improving your overall health (which both you and your provider(s) will receive a copy of);
  • Gives tips for your next appointment with your provider; and
  • Will help increase your knowledge about pharmacists and how you can depend on them as a resource.

RX Review Process

 

How the Program Works:

If you have qualified for this program, you will be receiving an introduction program packet. This letter will outline the Rx Review Program. Within 10 days of receiving this letter, a pharmacist will contact you to set up an appointment. The pharmacist will identify themselves as an Rx Review pharmacist and ask some preliminary questions to ensure you will benefit from this consultation. Once you feel comfortable you may move forward with scheduling a meeting, either in person or over-the-phone. These pharmacists are highly trained in advising members about medications and addressing any concerns you may have.

At your Scheduled Consultation:

You should begin by going over any health concerns and your medication history with the program pharmacist at the beginning of either your in-person or over-the-phone consultation. By doing this, the pharmacist will be able to understand how well your medications are working for you and how well you understand their purpose. They will go through each drug you take, looking at the use and its intended indication. At the end of your one-hour consultation, the pharmacist will help you design an action plan and make and suggestions on how you could improve your overall health outcomes and medication routine. Please remember to ask any questions that may come to mind and address any concerns you have with your Rx Review pharmacist.

What Happens After your Consultation?

After your consultation has been completed the pharmacist will create a letter that summarizes your conversation and the recommendations they have made. This recommendation letter will be sent to you and the healthcare team that you identified. We ask that you follow-up and schedule an appointment with your healthcare team to go over these suggestions. If you or your provider(s) have any questions, you can direct them to the Rx Review Program Manager. Please note, the Rx Review pharmacist is only making recommendations, your healthcare team will make the final decision.

 

Frequently Asked Questions (FAQ)

Why an Rx Review Pharmacist and not Mine?

Our pharmacists have received specialized Medication Therapy Management (MTM) training that makes them highly qualified to provide this service to you. Your healthcare team is working towards the same goal to improve your overall health. However, a pharmacist's main objective is to understand each medication in today's market and how it can affect and benefit a member. Whereas a provider's objective is to understand the entire scope of healthcare, not solely to focus on medications.

Does my Provider know About this Program?

If you receive an Rx Review Program letter, that indicates it was sent to you and only you. There is a chance that your provider did not hear about this program. Therefore, they are more than welcome to reach out to the Rx Review Program Manager to obtain more information and get any questions answered. If we do believe you are a "high priority", or could greatly benefit from this program, then we will reach out to your provider or care coordinator to help facilitate your participation in this program.

Why me?

We believe you could greatly benefit from this program based on the claims data we received. This isn’t bad, nor will this bring any barriers into future access to care. The purpose of this program is to provide another resource to help you improve your knowledge about your medications and your overall health.

Who else is doing this? 

All private insurances and Medicare have their versions of MTM programs that are offered to their members. We would like to offer you the same kind of resources.