MagellanRx provides full-service pharmacy management solutions for prescription benefits. Magellan desired to create a tool to quickly analyze pended cases in various queues, develop a utility to upload PDF documents into the production system, and to document clinical answers in a dedicated location.
To manage work more efficiently, TDK developed a tool to evaluate MagellanRx requests flagged for further review and placed them in a queue according to the action needed. New elements include a summary view to display all pended cases by queue and by client. Both views sort the cases according to age. When a client is selected, the pended cases display high-level pertinent details. The enhancements also provide users an option to display more detailed case information, where they can filter threshold cases to specific clients, queues, and programs by priority, lines of business, action types, or request types.
TDK also developed a utility giving specified users the ability to upload PDFs directly into the production system, which allows MagellanRx to easily update guidelines for each drug. When loading, the user enters the date the document is to become active. The specified users are allowed the ability to edit the activate date once the document is loaded. When new documents are loaded, the previous versions are archived and stamped with the activate date and expiration date. When an archived document needs to be referenced, specified users can search archived documents by client, lines of business, and drug.
To assist MagellanRx in complying with Federal regulations stating the same information may be requested one time only while processing a request, TDK routed all answers to a dedicated section of the application with reportable fields. Having all the clinical answers in one location helps users more quickly determine why a given case is pended to their queue. This solution allows clinical answers to be edited at the review level. Once an answer is edited, the algorithm is re-invoked to display the next appropriate question. All answers given during the request process are captured and stored, with the most recent ones displayed in the dedication section.
TDK and Magellan worked collaboratively, utilizing weekly status meetings to complete the projects. This process ensured that TDK fully understood project requirements and that Magellan received exactly what was expected in the completed projects. TDK provided regular demonstrations of completed work so Magellan could see first-hand the progress of the development and provide feedback. The added functionality delivered by the projects provides the MagellanRx team the ability to work more quickly and effectively, which ultimately provides better service to their clients.