The Gold Standard of Formulary Management
Incorporate the latest drug management techniques to appropriately balance control and efficiency through DRG/Adaptive’s formulary management application. RxFlex takes the complexity out of the designing, building, and on-going management of drug lists, formularies, criteria, and published materials, all while fostering Control, promoting operating Cost Optimization, and aiding Compliance.
Manage Formularies and Utilization Management Edits Efficiently
Create and maintain formularies and utilization management edits manually or leverage RxFlex’s powerful auto-rules engine, which drives an 80% reduction in weekly maintenance. RxFlex was designed to replace manual processes with capabilities you can trust. For all lines of business, across clients, never make the same change twice.
- Create new formularies, copy existing ones, or make bulk changes to multiple formularies in just a few clicks
- Create and manage benefit level coverage lists, clinical programs, exclusion and Part D submission files
- Intuitively manage auto-tiering rules for new-to-market drugs, line extensions, and new NDCs
- Modify formulary coverage decisions at the drug attribute level
Single Source of Truth
RxFlex is your organizations source of truth for formulary coverage decisions. By eliminating the need to enter and store identical information across multiple systems, DRG/Adaptive ensures there are no discrepancies with downstream stakeholders.
- Claims Integration: DRG/Adaptive is the only formulary management provider able to ensure complete data consistency through direct integration with claims adjudication systems.
- Manage and Publish Required Member Documents: customize and generate marketing documents, and effectively communicate benefits to members.
- CMS Submissions: whether creating new formularies or complying with CMS monthly maintenance requirements, RxFlex will help ensure your Medicare Part D formularies are approved the first time.