MeridianRx offers Medicaid, Medicare Part D, and Commercial formularies with the flexibility to customize as needed. Our formularies include a range of tiers, with a focus on coinsurance or dollar copayments, including generic and brand at the retail, mail and specialty distribution level. MeridianRx programs allow our clients to experience significant savings on Average Wholesale Pricing (AWP) and dispensing fee costs across all tiers.
MeridianRx clients have instant access to information about pharmacy reimbursements, rebates, the Maximum Allowable Cost (MAC) list, and administrative information on our MERLIN platform. This enables clients to utilize the data they need for optimal decision-making and efficiency. In addition, we offer our clients the ability to share specific portal access with their members and providers.
MeridianRx Clinical Services help optimize pharmacy care and costs for clients and members. Our current Clinical Service offerings include:
- 24/7 Access to Clinical Pharmacists
- Point of Services (POS) Drug Utilization Review
- Post Service Drug Utilization Review
- Prior Authorization Review
- Customizable Clinical Programs
- Pharmacy Case Management (for high risk members related to COPD, CHF, Asthma, and Diabetes)
- Pharmacy Population Management (for all members requiring preventive health care services related to NCQA, HEDIS®, and CMS)
MeridianRx provides Specialty Pharmacy services through a complete source model. Utilizing MERLIN, our proprietary technology platform, our clients and their members receive personalized patient support services and tailored medication management programs for complex health conditions. Our MeridianRx Specialty Pharmacy team guides prescribers to the appropriate specialty medications, based on efficacy and cost. Members receive friendly, clinically-accurate support to assist them to:
- Take or administer medications as prescribed
- Manage any medication side effects
- Monitor symptoms and responses to therapy
- Get counseling on health conditions
- Coordinate new and refill prescriptions
- Work with insurers to verify benefits
