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MCS develops app to optimize healthcare operations

By on July 11, 2019


Rx Pharmacy helps improve service to Medicare members

SAN JUAN — Puerto Rico managed healthcare plan provider MCS has launched Rx Pharmacy, an application to allow the more than 1,000 pharmacies in its network to process prescription drug pre-authorizations through an online system.

The objective of adopting the new technology is to replace the manual process, “thus facilitating members’ access to the prescription drugs they need,” MCS said in a release, adding that as an added-value, the tool fosters “teamwork with the pharmacies to optimize business operations and streamline the services provided” by MCS Advantage to MCS Classicare members.

Pharmacies belonging to the MCS network first register at a central portal——to be able to begin offering the streamlined service.

“At MCS, we are pioneers in implementing this virtual system, which will improve communications between the pharmacies and the medical plan, while reducing medication pre-authorization wait times. For example, for expedited medications, we expect to reduce the pre-authorization time from 24 hours to an average of just 12 hours. And for standard 72-hour medications, an average of 36 hours. That way, we can ensure our members keep their health conditions under control,” Dr. Carolyn Rodríguez, executive vice president of Pharmacy at MCS, said in the published announcement.

Rodríguez explained that the industry conducts the pre-authorization process by fax, an antiquated and cumbersome process.

“However, with Rx Pharmacy, we will be able to streamline the prescription drug pre-authorization process, which will help prevent duplicate faxes, reduce hardcopy expenses, and provide the real-time status of each case. It will also result in a virtual database, allowing the pharmacy and the member to be quickly informed of the pre-authorization status of a much-needed medication,” she said.

MCS’s CEO, Jim O’Drobinak, added that the move is a reflection of the company’s commitment to ensure that its provider network offers the best services possible.

“In order to provide quality health care, it must be based on automated processes that speed up the operation of the business. Only then can better service be provided to our members. That’s why it’s essential that providers incorporate the necessary technological solutions into their operations. And because we are aware of this, we used our in-house talent to develop and implement the Rx Pharmacy application, which will allow us to work as a team with our pharmacies to further improve the health care we currently offer to our members,” O’Drobinak said.

At the Puerto Rico Pharmacists Convention, which will be held Aug. 15-16, MCS will deliver an educational talk on pre-authorizations and Rx Pharmacy’s features, including its ability to generate reports for business operations. The talk will be worth three continuing education credits.

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