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(Dallas, Texas, March 13, 2006) - NEXTcare management, a subsidiary of ppoNEXT, announced today a new product offering: Medicare Part D Prescription Appeal Review. NEXTcare management has positioned itself to provide an independent third party review of the denial of any Medicare Part D prescription drugs that were denied by one of the 25 Pharmacy Benefit Managers (PBM) approved to handle the Medicare/MediCal business. Prescriptions for exceptions or non-formulary drugs may also be reviewed for medical necessity. These appeal reviews will satisfy the Federal requirement for the Medicare Part D denied prescriptions.
Medicare Part D Prescription Appeal Review is a valuable service for any Health Plan, Union, or large employer who outsources their Medicare Pharmacy benefits. NEXTcare management will work hand in hand with the PBM in delivering high quality appeal reviews within the designated time frame of 72 hours. This service is available 7 days a week, 365 days a year. NEXTcare management has a solid history of providing care reviews; consequently, adding the Part D review has been a smooth transition.
"What makes this product so valuable is our ability to provide these reviews after hours, on weekends, and on holidays, meeting the Medicare requirement by treating every appeal as an expedited request," says Mary Cassol, VP of NEXTcare management. We are very excited about this product offering and expect our clients will benefit greatly from the satisfaction that their participants are being cared for with such a sense of urgency."
About ppoNEXT:
Founded in 1999, ppoNEXT is a leading provider of health network services aimed at assisting companies, and therefore, consumers with managing the spiraling cost of healthcare by actively participating in Consumer Driven Healthcare initiatives. These initiatives hold great promise as mechanisms to aid employers in gaining control over the cost of employee health benefits. ppoNEXT is dedicated to providing services that are like-minded; realizing that companies who meet the challenges faced by opening the healthcare marketplace will be at the forefront of delivering on that promise. Based in Long Beach, California, ppoNEXT offers clients access to over 450,000 physicians, 3,700 hospitals, and thousands of leading ancillary care providers nationwide. ppoNEXT serves self-funded employers, third party administrators, insurance carriers, HMOs, and bill review firms. Through its subsidiary, NEXT care management, ppoNEXT offers disease management, utilization management and care management services.
For more information about ppoNEXT, please contact:
Etta Jones
Corporate Marketing
214.267.3394
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