Benefit Administrators Introduces a Cashless Payment System for Prescription Drugs for HSA Accountholders

Lafayette, CA – October 13, 2004 – Debit cards have been introduced by many Third Party Administrators (TPAs) as the panacea for immediate reimbursement of qualified medical expenses. Have they truly worked in the marketplace?

Medical expenses can be broken down into 4 main expense categories: doctor’s visits, x-ray & lab, hospitalization and prescription drugs. With most health plans and insurance companies’ medical plans, there is typically an underlying preferred provider organization (PPO) network in place to assure its members the lowest possible negotiated discount rate. Prescription drugs are in a category of its own usually managed by a third party pharmacy benefit manager (PBM). Debit cards work on a real time basis and are not in sync with an environment whereby the medical claim needs to be adjudicated and re-priced by the underlying health plan. Sure a provider loves the idea of swiping a debit card at the time of service for immediate payment but is it the best option for the consumer? There is no guarantee that the consumer is paying the negotiated discount price afforded by his health plan provider since the claim did not go through a real time adjudication and re-pricing.

Typically, the current business practice is for the consumer to seek medical service, wait for the claim to be adjudicated and re-priced by the health plan, and receive a confirmation (EOB) for his/her patient responsibility portion and then pays the provider. Until such time when the health plan allows a third party vendor such as a TPA access into their claims adjudication/re-pricing engine, point of service reimbursements through debit cards can end up as more work for the administrator for claims substantiation and reconciliation.

However, in the category of prescription drugs, whereby it is managed by a pharmacy benefit manager, a real time claims re-pricing can take place at the time of service.
Benefit Administrators, a TPA for Health Savings Accounts (HSAs) have launched its cashless prescription drug discount network marketed under MyRxSavings. HSA accountholders typically have a high deductible option and prescriptions are subject to the plan deductible with no first dollar benefit or copays. Furthermore, many accountholders with high deductible options do not have a prescription discount benefit and are subject to the pharmacy maximum retail price for their medication. Benefit Administrators have introduced to its current accountholders a national pharmacy network with over 54,500 participating pharmacies discounting prescriptions from 13-60% from the manufacturer’s suggested retail price. Participating pharmacies includes well known chains such as Long’s, Walgreen’s, Safeway, OSCO, Rite-Aid, CVS, etc. along with many independent pharmacies. Benefit Administrator’s HSA accountholders simply present their pharmacy ID card at the time of sale and the prescription will be dispensed without any money out of pocket from the accountholder. Behind the scenes, there is a business relationship between the pharmacy and Benefit Administrators to debit the HSA accountholder for the cost of their medication and remit payment directly to the pharmacy.

As a valued added service to the growing HSA market, Benefit Administrators is providing the discount pharmacy network along with its cashless pharmacy payment process at no additional charge to its accountholders.

If you would like more information about Benefit Administrators or the MyRxSavings Prescription Discount Card, please contact Ernest Lee at 925-299-8015 extension 8888 or
email: ernie@eglee.net