PBM Solutions

Industry leading workers' compensation solutions built on clinical expertise and robust data

MyMatrixx by Evernorth achieves better outcomes by keeping our products and services aligned with a few core objectives. Specifically, our goal is to provide clinical value, innovative technology and actionable data analytics — all squarely focused on workers’ compensation patient advocacy. Combined with industry leading customer support and access to one of the largest pharmacy networks, MyMatrixx has everything to realize any claims management strategy and pharmacy management.

Our unique position as a pharmacy benefit manager (PBM) with a dedication to injured workers means we can tailor solutions to the specific needs of each client. Flowing from this idea is a powerful set of PBM services and tools designed to achieve positive outcomes and return injured workers to the job while keeping patient safety as the highest priority.

MyMatrixx PBM solutions deliver:

Clinical value and capability: Our clinical team understands the specialized nature of work-related cases and has developed a range of pharmaceutical review and management programs. With customizable formularies, step therapy to ensure generic efficiency and proactive clinical alerts, injured workers receive clinically appropriate treatment while mitigating unnecessary prescription medications. MyMatrixx also delivers unparalleled access to a nationwide network of retail pharmacies.

Actionable data analytics: The ability to analyze decades of case management data leads to increased predictability and stability with claims. With myDataSense business analytics and reporting and our CARE workers' compensation software engine, we turn raw data into useful information that helps injured workers achieve positive outcomes and clients achieve their larger claims strategy.

Product innovation with technology: We’re committed to a secure and frictionless customer experience across our product line. MyMatrixx offers a user-friendly and patient-centric claims portal and adjudication platform. We also deliver accurate electronic billing and out-of-network bill management as well as full oversight for paper billing and physician-dispensed medications.

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Clinical capabilities

We practice proactive clinical management with the goal of improving patient outcomes, preventing avoidable medical expenses and reducing pharmacy costs. We base our workers' compensation solutions on “doing the right thing” for patients and our clients.

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Data and analytics software

We deliver actionable insights based on pharmacy trends that you can use to help you make educated, effective decisions. Our products such as myDataSense and our Clinical Analytics Results Engine (CARE^SM) are built from a proprietary data warehouse and can be customized for the specific needs of a client.

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Innovation and technology

Our technology provides claims professionals with a single online tool to manage pharmacy and clinical programs in a secure environment. With innovative technology, we designed a unique web portal that provides full access to critical information to better manage costs, utilization and clinical concerns.

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Customer service

We’re proud to set the standard in delivering the best client and customer service in the industry. Our goal is to provide a customer experience that integrates seamlessly with our clinical solutions and technology to stay laser-focused on patient needs.

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Transparent claims management

Clients should expect clarity and consistency from their PBM services. MyMatrixx combines custom-tailored solutions with the scale of our parent company Evernorth to make workers' compensation claims management more transparent, predictable and affordable for our partners.

We know workers’ compensation pharmacy benefit management.

It's who we are.

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