The primary purpose of the Clinical Intervention Center pharmacy staff is to provide clinical support services to long term care dispensing pharmacies for multiple states. These services include:
• Supporting Omnicare pharmacy operations by assuming responsibility for more cumbersome, time-consuming clinical assessment and intervention on prescribed medication therapy.
• Managing rejected clinical claims by requesting to prescribers a “covered” alternative to a drug product that has been denied for reimbursement by a third party prescription plan such as Medicare Part D, commercial insurer or Medicaid, and making changes to existing orders within the pharmacy operating system based upon the response of the prescriber.
• Initiating Prior Authorizations or Medical Exceptions based upon information from the patient’s medical records when required by the payer.
• Delivering Medication Therapy Management (MTM) services by licensed pharmacists to optimize safe and effective medication use.
• Generating Patient Specific Therapeutic Interchange requests for prescribers for cost savings or a clinically superior drug to that drug originally prescribed by the clinician, and making changes to existing orders within the pharmacy operating system based upon the response of the prescriber.
• Implementing Facility Formulary preferences for prospective medication changes on dispensing.
• Coordinating specific National Account or multi-chain customer requests.