Our Innovative Approach to
Pharmacy Benefits Management

Based on the direct Italian translation, “to think,” PENSA Health Management was founded in 2007 by Scot Giambruno. The best ideas are usually simple. You can count on our company to think through the pros and cons of every element and brainstorm for fresh, new ideas. When an industry is so complicated, its services and the providers become so weighed down in new rules, regulations and changes that almost every person or component forgets to do something very simple—think. Our pharmacy consultants think clearly and in fresh ways, with dedicated considerations of your unique needs--providing you with a straightforward plan designed with your unique benefit management services needs in mind.

Pharmacy Benefits Procurement You Can See Right Through

PENSA’s thoughtful, considered approach to pharmacy consultants services, pharmacy benefits procurement and benefit management services results in fresh, cost-cutting, client-focused pharmacy benefits management services designed to eradicate confusion and give you the reduced-cost results you deserve.

Cost-Cutting and Cutting Edge Pharmacy Benefit Management Service

Our pharmacy benefits management company lifts the veil on the healthcare industry’s complicated and confusing approach to its provision and explanation of benefits.

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Discovery

  • Review Pharmacy Benefit Plans
  • Analyze Competitiveness to Best Practices
  • Analysis and Development of Pharmacy Benefit Cost Containment Strategies
  • Vendor Procurement of PBM Services
  • PBM Vendor Contract Negotiations

Vendor Procurement

  • Development of Client-Specific Request for Proposal (RFP)

Analysis

  • In-depth Analysis of Vendor RFP Submissions (Technical, Operational, Financial,
    Account and Customer Service, Performance Guarantees)
  • Modeling of proposed financial offers per contract terms
  • PBM vendor selection guidance

Contract Negotiations

  • Negotiates Best in Class terms on behalf of the client, based on current market trends:
  • Technical
  • Operational
  • Financial
  • Account and Customer Service
  • Performance Guarantees

Implementation

  • Develop Outline of Specific Tasks and Timelines
  • Manage Weekly Implementation Conference Calls with Vendor and Client
  • Resolution of Outstanding Issues
  • Assure Appropriate Implementation of Contract Terms
  • Comprehensive Pre “Go-Live” Implementation Test

Oversight & Performance Management

  • Continuous Oversight of PBM Performance
  • Handling Specific Pharmacy Benefit Issues on a Daily Basis
  • Analysis and Recommendation of Quarterly PBM-Recommended Formulary Drug
    Charges
  • Annual Review and Reconciliation f Client-Specific Performance Guarantees and
  • Resolution with PBM (e.g., GER, GDR, rebates, etc.)
  • Review and Development of Recommendations Regarding PBM Clinical Programs (e.g., Quantity Level Limits, Prior Authorizations, Etc.)
  • Quarterly Claims Reimbursement Validation

What Results Can You Expect

  • Markedly Improved Levels of Service
  • Thoughtful, Unique and Innovative Programs
  • A Significant Improvement for Your Bottom Lin

Customize Benefit Management Services with Proven Cost-Cutting Result

PENSA prides itself on the customized solutions it has developed for numerous customers in key healthcare verticals. With a successful track record of positive results since its inception, PENSA has influenced nearly a billion dollars of positive ROI with its contract negotiations, process improvements and innovative programs across the healthcare spectrum.

With great results like these, imagine the good that PENSA can do for you.