ezURs.com provides independent pharmacy review services that help to achieve goal, by providing an objective, evidence-based solution. Our pharmacy review services plug seamlessly into your claims and drug utilization review workflow, allowing you to make member pharmacy benefit determinations with fairness, objectivity, accuracy and timeliness. Overuse of medications can inhibit patient wellness. Our Pharmacy Benefit
Reviews take into consideration drug price, utilization and appropriateness of medications within the scope of the treatment plan. Our team of qualified specialists and physicians make sure that the medications being prescribed are needed and providing a benefit to the course of treatment. We focus on the patient and the desired outcome while ensuring the right drug, at the right amount, providing the right treatment.
The retrospective pharmacy program involves reviews of patient drug history profiles generated from medical assistance paid claims data by a panel of active practicing physicians and pharmacists.
The reviews are based upon predetermined standards consistent with the following:
- American Medical Association Drug Evaluations
- United States Pharmacopoeia-Drug Information
- American Hospital Formulary Service Drug Information, and
- Peer-reviewed
Our staff of in-house physicians perform all drug benefit reviews, by reviewing case records, applying your formulary and the latest clinical evidence to make an objective determination of coverage. Our standards-based review services provide the confidence to your members that they are receiving an objective review of their benefits, and ensures the integrity of your services.
The retrospective review of the patient drug history profiles by the panel of reviewers includes evaluation for:
- Therapeutic appropriateness
- Over and under utilization
- Appropriate use of generic products
- Therapeutic duplication
- Drug-disease contraindications
- Drug-drug interactions
- Incorrect dosage or duration of therapy, and
- Clinical abuse/misuse
pharmacy review services plug seamlessly into your claims
Retrospective DUR
The retrospective DUR program involves reviews of patient drug history profiles generated from medical assistance paid claims data by a panel of active practicing physicians and pharmacists. The reviews are based upon predetermined standards consistent with state and federal guidelines
Prospective DUR
The prospective DUR program focuses on educating prescribers and members on benefits, drug safety and prior authorization reviews. The concurrent DUR program helps to stem safety, benefit and drug issues at the point of sale.
Concurrent DUR
The two most common problems with prescription drug usage are the potential for drug interactions and the lack of drug compliance. Both can lead to harmful results. Concurrent Drug Utilization Review (DUR) addresses these issues right at the dispensing counter. Drug interactions, duration and dosage are carefully reviewed by our experienced peer review panel.
Pharmacy Peer Review
Our Pharmacy Peer Reviews focus on ensuring prescribed medications are
appropriate and necessary to treat the injury while restoring the health and productivity of the injured worker. Our clinical pharmacists and peer reviewers review the pertinent medication regimens and medical records and recommend alternatives to prescription patterns based on medical necessity, treatment guidelines and clinical best practices.
