AWPRx

AWPRx
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Pharmacy management provider prescribes Jitterbit to automate business processes.

As a pharmacy benefit manager, AWPRx connects to 70,000+ contracted pharmacies in their national networks to process thousands of workers’ compensation prescriptions every day. That requires fast integration with insurance information and workers’ compensation claims to make sure that employees in need receive the right medications, at the right price, as quickly as possible. By making use of electronic billing and automatic data integration, AWPRx helps companies save money, speed up processes, and take their pharmacy benefits completely paperless.

Making the right drug and price information available instantly is a key component of the value AWPRx provides its customers. For more than seven years, AWPRx has relied on Jitterbit to provide a fast, automated connection between AWPRx’s internal systems and a national pharmacy network made up of more than 95 percent of U.S. pharmacy providers, including CVS, Kroger, Rite Aid, Target, Walgreens, and Walmart. This connection is what lets AWPRx verify information and process claims fast and accurately.

AWPRx depends on Jitterbit to make the right data available when and where it’s needed. Every few minutes, AWPRx receives workers’ compensation claims and insurance details from client organizations. Jitterbit automatically sends that information between Salesforce, pharmacy networks and client systems to verify eligibility and get the right prescriptions dispensed quickly and affordably. The client can make an informed decision on the medication in minutes.

Because Jitterbit adjusts automatically to any changes in source file formats, AWPRx no longer has to make cumbersome manual updates if network members modify source files. Jitterbit also makes sure that information from clients, clearinghouses, and pharmacies is reflected appropriately in ForceRx (Salesforce, customized for AWPRx), so anyone at the company can see the current status of any claim.

In addition to automating claims handling, Jitterbit powers the AWPRx partner portal, which shows accurate medication information with up-to-date prices, enabling partners to make smart benefit decisions. Workers’ compensation laws and requirements vary by state, so Jitterbit also automatically delivers EDI 837 compliance records to state agencies in the appropriate formats. Without Jitterbit, all of this crucial information exchange would have to be handled with custom code or manual intervention, taking up valuable time and opening up the risk of inaccuracy.

Using Jitterbit allowed AWPRx to replace its Oracle database with Salesforce, which reduced its integration budget by 80 percent and achieved a 300 percent return on investment in just one year. The company no longer has to spend money on extensive support, training, and development for its Oracle data center, or spend time engaging in tedious manual intervention to resolve data discrepancies. Instead, AWPRx can now focus on providing better service to its many customers with fast access to data from a large network.

Technology moves at a fast pace, and things change rapidly – including file formats and data requirements. But seven years after the initial implementation of Jitterbit, the savings keep adding up and the Jitterbit platform continues to manage every data feed and type that is thrown at it. The stable, mature Jitterbit integration keeps AWPRx operations up and running at a low cost with minimal maintenance. Occasionally, an AWPRx client will change a specification, but it’s quick and easy for AWPRx to update the Jitterbit connection to accommodate that change.

For AWPRx CEO Jay Roy, “No news is good news.” The Jitterbit integration continues to work behind the scenes, connecting core business processes with the information that they need to provide clients with the right drug, at the right time, at the right price, and support a paperless benefits program that automatically accommodates the fast pace of the healthcare industry.

Organization

AWPRx

Integrations:

Salesforce, Pharmacy Network, EDI, Amazon Web Services, Force.com, Google Apps, Oracle, IBM AS/400

Challenge

  • Using custom code to make Cast Iron integrations work
  • Processing large volumes of data from hundreds of sources, and from on-premises systems into the cloud
  • Migrating infrastructure to cloud
  • Providing data replication into cloud data warehouse
  • Handling different EDI compliance rules for different states and sending attachments
  • Responding quickly when clients change specifications

Results

  • Saved more than 80% over previous solution and realized $400,000+ ROI in first year
  • Fast migration from on-premise infrastructure to Salesforce and Amazon cloud
  • Automated claims processing and client eligibility checks
  • Able to respond quickly to changes in client file specifications, without disrupting integration
  • Tapped into national network of more than 70,000 pharmacy benefit providers
  • Send EDI 837 compliance records to state agencies
  • Integration still up and running after more than seven years

AWPRx Integration Q&A

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