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Tiered Pharmacy Network
California Level A
Pharmacy Directory
Current as of January 1, 20181IntroductionHow to read the directorate Blue Shield of California Tiered Pharmacy
Network Directory is a
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How to fill out tiered pharmacy network
How to fill out tiered pharmacy network
01
To fill out a tiered pharmacy network, follow these points:
02
Determine the goals and objectives of the tiered pharmacy network.
03
Identify the criteria for pharmacy tiering, such as cost, quality, and access.
04
Evaluate potential pharmacy providers based on the established criteria.
05
Establish tiers or levels for pharmacies based on their performance and adherence to the criteria.
06
Develop a network agreement or contract with the selected pharmacies.
07
Communicate the tiered pharmacy network to relevant stakeholders, such as employees or members.
08
Monitor and evaluate the performance of pharmacies in the tiered network.
09
Make necessary adjustments or changes to the network based on the evaluation results.
10
Continuously review and update the tiered pharmacy network to ensure it aligns with the goals and objectives.
Who needs tiered pharmacy network?
01
Various entities may benefit from implementing a tiered pharmacy network:
02
- Health insurance companies or payers who want to manage pharmacy costs while maintaining access to essential medications.
03
- Employers who provide health benefits to their employees and want to offer cost-effective pharmacy options.
04
- Pharmacy benefit managers (PBMs) who aim to optimize pharmacy services and control spending.
05
- Government agencies or programs seeking to improve healthcare efficiency and reduce overall costs.
06
- Healthcare providers or accountable care organizations (ACOs) focusing on population health management and value-based care.
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What is tiered pharmacy network?
A tiered pharmacy network is a network of pharmacies that are categorized into different tiers based on cost and quality.
Who is required to file tiered pharmacy network?
Health insurance companies or pharmacy benefit managers are required to file tiered pharmacy network.
How to fill out tiered pharmacy network?
Tiered pharmacy network can be filled out by providing information on the different tiers, including the pharmacies included in each tier, cost-sharing requirements, and quality metrics.
What is the purpose of tiered pharmacy network?
The purpose of tiered pharmacy network is to offer consumers access to a range of pharmacy options that may vary in cost and quality.
What information must be reported on tiered pharmacy network?
Information that must be reported on tiered pharmacy network include the list of pharmacies in each tier, cost-sharing requirements, and any quality metrics used to categorize pharmacies.
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