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Effective Health Systems Updates Pharma Pre-Auth Program

October 19, 2011 - WorkCompWire

Los Angeles, CA – Effective Health Systems, announced that as part of its regular updating of its database system, the Pharmacy Pre-Authorization Application increased the total number of NDC codes by 13% and the number of NDC codes available for approval increased by 21%.

James Schlueter, Effective Health Systems’ President, said “BaseLine’s Pre-Authorization Application streamlines the approval process in workers’ compensation medical management and eliminates the guesswork from deciding which medical treatments, procedures, drugs, DME’s should be approved at the frontline level. It quickly identifies which requests should be approved versus those that should be escalated to a higher-level medical review. Thereby, injured workers can get the treatment they need with less delay and administrative costs.”

The core of BaseLine’s NDC Database is supported by on-going research conducted by the Work Loss Data Institute (WLDI) and is regularly updated. Phil LeFevre, a Senior Executive with WLDI, said, “We are excited to be working with Effective Health Systems. Their BaseLine technologies deliver WLDI and ODG research effectively and efficiently across the industry.”

Schlueter said, “The NDC acts as a universal product identifier and includes additional information such as dosage and drug form. Within the BaseLine Pharmacy Database, the NDC codes are linked with the ODG Workers’ Comp Drug Formulary. The database links information on Drug Class, Generic Name, Brand Name, Generic Equivalent and the ODG proprietary Preferred Drug Status. Thus, users can easily identify whether specific drugs are recommended as first-line treatment in ODG based on evidence-based recommendations at the same time they review any other medical procedure, service or DME product.”

Gregg Bernhard, Effective Health System’s COO, stated, “BaseLine’s Pre-Authorization Application contains hundreds of thousands of rows of data from multiple sources aimed at facilitating best practices in healthcare. Our goal is to expedite needed care to injured workers, contain costs and control questionable and/or unnecessary medical treatments.”

Source: Effective Health Systems

Filed Under: Industry News, Top Stories, Workers' Compensation

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