The TeleCLAIM++ PBM system is an Internet Browser based (MS Explorer) processor. It provides complete familiarity with the user because of its sameness with common Internet standards. This enables quicker user orientation and skill development. The screens contain Help pop-ups when needed by the user thereby minimizing errors fostering maximum productivity. All screens have evolved for ease of use by feedback from users for over 10 years of activity. Several representative samples are provided below.

 TeleRx MENU SCREEN

PRE-PROCESS POS SCREEN

 POST-PROCESS POS SCREEN

TELEVISTA - MENU 

TELEVISTA -  INVENTORY ACTIVITY

 TELEVISTA - MEMBER UTILIZATION

 PLANBUILDER PAGE 1- CLASS EXCLUDES

 PLANBUILDER PAGE 3 - INGRED.COST

 PLANBUILDER PAGE 6 - LIMITS

 PLANBUILDER PAGE 10

 POST-PROCESS POS SCREEN

.HOME    NEXT

TeleRx is the system POS module. The sample shown on the left is the Home screen that provides a menu of various order functions. Also contained in the menu is the link to TeleVISTA - the report module that provides immediate access to 38 drill down reports that are real-time for up-to-the minute accuracy .

The sample to the left illustrates the screen provided for populating with the Rx facts for filling the screen. The first entries are name identity and the drug ordered. Both items are quickly selected by the AJAX tool.  AJAX immediately displays database records that match to each character entered which greatly expedites populating the key items.

To your left is the screen returned after adjudication of an Rx order. It displays all populated entry data and the results of adjudication. The primary results displayed are the calculated Co-pay, and the amount of reimbursement for the Provider store. The newest version of TeleRx allows up to 4 separate Rx entries for any member.

  TeleVISTA provides 38 different reports useful to all interested parties to the PBM process: Patient, DrugStore, Physician, Administration and Sponsor Management. Each has several reports that are generated dynamically to drill down to specific areas of interest and for specific date spans.

< An example of an inventory  report created by DrugStore that accounts for the summary of inventory dispensed over a designated span of days.

< An example of individual member utilization over a designated span of days. One version lists utilizaing summary by individual with greatest dollar value as the sort sequence.

PlanBuilder is the module that creates individual Benefit Plans. Each plan is an unconnected entity that may be invoked for any group that is defined with in the system. Groups may be one or more individual members. A group belongs to a Division which in turn belongs to a company/client. The sample to the left is one of 10 pages in PlanBuilder that excludes entire classes of drugs in order to simplify the Plan development (rather than defining each drug that should be excluded).

<< Another PlanBuilder example page that defines how to treat the determination of Ingredient cost in the calculation of CoPay and provider Reimbursement. The template involves separation of brand versus Generics as discounts are applied indivduallyfor the greatest flexibility in influencing the lowest costs tothe Plan Sponsor.

 << PlanBuilder Page 6 which designates various limits based on certain special conditions.

<< Another PlanBuilder (Page 10) that designates a variety of editting functions important to the Plan definition.