Pekin Insurance is a national insurance provider with more than 700 employees, 1,200 agencies, and 7,500 independent agents. They partnered with CorVel in 2009 for their bill review, case management, pharmacy and specialty network programs. Since then, CorVel has delivered proven program results and statistics.
Using CorVel’s integrated pharmacy and bill review systems, Pekin was able to capture 100% visibility of all prescriptions, which allowed CorVel to proactively manage significant cost drivers in pharmacy utilization. CorVel’s system flags potentially problematic claims with certain narcotics or drug combinations, multiple prescribing doctors or inappropriate prescribing patterns.
Maximizing network penetration is also part of CorVel’s strategy. Protocols redirect claimants who visit out-of-network pharmacies and re-index claims received from third party billers to ensure subsequent prescription fills are processed. As a result of CorVel’s comprehensive pharmacy program, Pekin realized an average Pharmacy Benefits Manager (PBM) utilization rate of 98% compared to 68% at the end of 2010, yielding a savings growth of 11 percentage points in four years. Additionally, as PBM penetration increased, prescriptions from third party billers and other pharmacy sources decreased, evidencing the success of CorVel’s channeling and reindexing capabilities.
Pekin has enjoyed the ability to set specific account instructions including prior approval for specific medication, formulary management and physician prescribing. Going forward, Pekin plans to expand their program to also include full auto bill review and checkwriting.The company looks forward to continued savings and success with CorVel.