- Initial part D Coverage Determinations:
- Review coverage determination clinical denials for accuracy
- Review of coverage determination attempts and time frames to ensure compliance with Medicare standards
- Review documentation of coverage determination denials
- Level 1 Appeals or Redeterminations for part D Medications Service Offering from MCM Solutions:
- MCM Solutions has a team of clinical pharmacists with experience in part D programs and coverage determinations.
- We offer Level 1 Appeals or Redeterminations directly to Health Plans at a reduced rate as compared to typical PBM rates
- Rates are usually 25-75% lower than PBM rates
- Ability to integrate into Coverage Determinations PBM software and collaborate with internal team
Use the contact form for more informatoin.