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Pro Pharma Pharmaceutical Consultants
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ProData AnalyticsDelivering Quality Consulting & Analytics Since 1986
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Consulting
Financial and clinical evaluations accompanied by tools to manage the drivers of change.
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Concurrent Audit and Analyses
Pharmacy Invoice Analyses – Identify, Prioritize & Manage Rx Adjudication Issues
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Retrospective Audit
Pharmacy Audits & Management Prioritizing Corrective Actions Automatically
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Forecasting & Predictions
Artificial Intelligence to Forecast and Predict the Impact of Specific Factors on Population
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Pre-Certification of Specialty Medication
Prior Authorization Criteria with Efficacy, Dosing, Frequency, Combination Therapy & Cost
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Request for Proposal (RFP) Management
Vendor Proposals Evaluated Rapidly & Efficiently in a Customized Document-Linking Program
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Analytics
Rapidly, efficiently, and graphically utilize integrated claims data to customize your analyses.
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Specialty Medication Analyses
Analyze & Validate All Elements of Medical & Pharmacy Spend and Actions for Outlier Providers
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Fraud, Waste & Abuse
Identify FWA at Pharmacy, Provider, & Patient Levels for Interventions and Correction
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JCode Calculator
Identify Specialty Rx HCPCS, NDCs, Pricing, Dx, Usage, FDA Alerts and Genomic Tests
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Maximum Allowable Cost List
Customized MAC List – Transparent, Accessible & All the Savings Go to the Payers
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Comprehensive Medication Review (CMR) for Populations
Automated Review of Medication - Link to Billing, EMR, Patient & Prescriber Letters
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Clinical Compliance
Digital & Clinical Edits for Monitoring Medication Effectiveness and Risks
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Visit our Pharmacy Benefit News Page
We provide pertinent and relevant information on a regular basis to educate and to keep the general public well-informed with up-to-date healthcare information.
OUR SERVICES
Bringing Clarity to Healthcare Decision-Making with Analytical Tools
For Your Specific Consulting Solutions.
We offer a variety of services that integrate both pharmacy and medical data to solve healthcare problems.
Every service we offer is can be customized to fit your organizations individual need.
To learn more about the services we offer please click on the items on the right.
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Clinical Compliance
Digital & Clinical Edits for Monitoring Medication Effectiveness and Risks
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Comprehensive Medication Review
Automated Review of Medication - Link to Billing, EMR, Patient & Prescriber Letters
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Concurrent Audit and Analyses
Pharmacy Invoice Analyses – Identify, Prioritize & Manage Rx Adjudication Issuest
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Forecasting & Predictions
Artificial Intelligence to Forecast and Predict the Impact of Specific Factors on Population
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Fraud, Waste & Abuse
Identify FWA at Pharmacy, Provider, & Patient Levels for Interventions and Correction
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JCode Calculator 3.0
Identify Specialty Rx HCPCS, NDCs, Pricing, Dx, Usage, FDA Alerts and Genomic Tests
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Maximum Allowable Cost List
Customized MAC List – Transparent, Accessible & All the Savings Go to the Payers
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Pre-Certification of Specialty Medication
Prior Authorization Criteria with Efficacy, Dosing, Frequency, Combination Therapy & Cost
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Quality Managment Program
Improving Quality-Prescribing Decisions for Your Members, Without Having to Change your Benefits
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Request for Proposal
Vendor Proposals Evaluated Rapidly & Efficiently in a Customized Document-Linking Program
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Retrospective Audit
Pharmacy Audits & Management Prioritizing Corrective Actions Automatically
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Specialty Medication Analysis
Analyze & Validate All Elements of Medical & Pharmacy Spend and Actions for Outlier Providerss
Our Partners
Pro Pharma Talks
Weekly Discussion on Issues that Matter
Join us every week as Dr. Craig Stern and Alex Hernandez take on current healthcare tends, issues and news.
"Your professional support and efforts contributed to organizational redesign of systems, processes, and a re-evaluation of the way our teams can work better together. The ROI attributable to this project is greater than 2:1."
“The analyses and recommendations resulting from your work has set the stage for us to re-think and re-vamp the way we work and provide services to our members. Savings resulting from the various initiatives resulted in approximately $2.4 million, with another $10 million to be accounted for downstream as systems and processes accommodate to initiative recommendations”
“Pro Pharma is integral to the way in which we operate on a daily basis. Your consultative interventions provide assistance to our Case Managers with their education of our Members, management of Claims Payments for Injectable's, and expertise to the overall workings of the Plan”
Copyright © 2017 Pro Pharma Pharmaceutical Consultants, Inc.
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