Insight on Business

August 2015

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w w w . i n s i g h t o n b u s i n e s s . c o m A u g u s t 2 0 15 • I NSIGH T | 27 MEETING CLIENT NEEDS T ransparency is the word both Navitus leaders and clients use to define how the company is different from other pharmacy benefit managers. Seligman says allowing customers to see exactly where every dollar is going is unheard of in the industry. "We're an open book. People know what they are spending and why. Trends show us people are spending less year over year because they utilize our service," he says. "Clients are charged for the cost of the drugs — and receive all discounts and rebates — plus an administrative fee. It sounds so simple, but that's not usually how it's done." Due to its scale, Navitus is able to get discounts from drug manufacturers, which are then passed on to customers. Clinical expertise in putting together formularies — that's the list of drugs an insurer will cover — also plays a role in keeping costs down, Seligman says. e company employs a lot of pharmacists — including Seligman, who worked as a pharmacist earlier in his career — to look at the available options. "You would think it's simple, but the systems and decisions in place are quite complex and require multiple decisions being made when it comes to putting the formularies together," he says. Pharmacists are also available to approve pre- authorizations, too. Pharmacy expertise isn't limited to the people putting together the formularies. Many employees in Navitus' call center have pharmacy tech training so they are better informed to help answer customers' questions, Seligman says. Ludka says the call center — which is based in Appleton, although there is a smaller one in Austin — plays a vital role in the company's success. Calls come in from pharmacies with questions about a customer's benefits as well as from customers asking about coverage or maybe a particular medication. "Customer service is our cornerstone. When people call, we want a real person to be on the other end of the line. We also want any issues resolved with that first call so people don't have to call back," she says. "When the call ends, we want the person on the other end of the line to feel like we've met all of their needs." at's a part of the service Audra Bloom, employee benefits coordinator for the City of La Crosse, a Navitus client, says her employees enjoy the most. "Our members consistently mention the personalized service they receive from Navitus Customer Care. Of particular note is Navitus' accessibility. You always speak to a live person — and you can count on thorough and prompt follow-through," she says. Navitus' wholly-owned subsidiary — Lumicera Health Services — is an example of responding to customer needs. Lumicera is a stand-alone specialty pharmacy that follows Navitus' transparency lead. "We went down that path since we had clients come to us several years in a row asking for these types of services," Seligman says. "Specialty drugs are an area they really struggle with cost-wise. We looked at the issue and decided we could do it ourselves. It allows us to be more specialized and it's strongly integrated with what we do already. ese are an expensive class of drugs and our clients really appreciate that we're in this market." Compliance is another big issue for clients — especially those running government prescription plans, Ludka says. "We've heard from a lot of our clients that previous plans weren't compliant. Timelines and accuracy are very important to government clients," she says. "It used to be clients made decisions only based on cost. at's not the case anymore. ey want better customer service — both on the account management side and for their enrollees — and they want everything to be compliant with the government regulations." As with everything else in the health care and insurance industries, change is a constant. Seligman says Navitus is a nimble company that can easily adjust to rule and industry changes. rough it all, the focus remains on the customer and delivering them the best possible value, he says. "We're a true part of health care reform since we are helping people deal with rising costs and providing them too with high-quality results," he says. We're an open book. People know what they are spending and why. Trends show us people are spending less year over year because they utilize our service." — Terry Seligman, Navitus President and CEO

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