Benefits Manager Services

Smarter Solutions for Better Care

Empowering Benefits Managers with Advanced Solutions

PersonalMedRx offers Benefits Managers a suite of cloud-based applications designed to enhance patient care and streamline operations. Our services include prior authorization management, claims editing, data analysis, and formulary management, all aimed at improving efficiency and patient access to personalized therapies. By leveraging AI-driven analytics and seamless integration with existing systems, PersonalMedRx ensures that Benefits Managers can effectively manage costs while delivering high-quality care.

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Network Solutions

Credentialing

Simplified Credentialing for Seamless Provider Access

PersonalMed, powered by 4L Data Intelligence, streamlines the credentialing process to ensure fast, accurate, and compliant provider verification. Our advanced solution automates data validation, reducing administrative burdens while maintaining the highest standards of accuracy and security. With real-time updates and seamless integration into your benefits management system, you can efficiently onboard and manage healthcare providers, ensuring patients have uninterrupted access to trusted care. Simplify compliance, reduce risk, and improve network efficiency with PersonalMed’s cutting-edge credentialing solution.

Data Analysis and Business Intelligence​

PersonalMed Insights transforms and clarifies data streams from the PersonalMed membership applications through a secure, cloud-based, single point of processing. 

AI-driven analytics reveal new business opportunities and identify benefits management logistics in the moment, seamlessly, through previous engagements and relevant experiences. 

Data is extracted from all PersonalMed sources and analyzed. It is transformed into data streams: clear and meaningful channels relevant to each individual business.  

Streams are then clarified, analyzed, and delivered through visual representations of business performance and how your business can improve and grow. 

Software users need not be data engineers or have high-level training to engage with and extract deep meaning from Insights. 

Patient Solutions

HealthLink

Seamless Patient Engagement and Care Coordination with PersonalMed HealthLink

As a benefits manager, you need a solution that enhances patient engagement, streamlines communication, and simplifies healthcare management. PersonalMed HealthLink is an innovative online platform designed to connect patients, providers, pharmacies, and health plans in one seamless experience. By integrating health records, prescription management, and direct communication tools, HealthLink reduces therapy abandonment and improves medication adherence. Patients can easily access their EOB health plan details, receive personalized medication guidance, and connect with their care team—all in real-time. With PersonalMed HealthLink, you can ensure better health outcomes while optimizing efficiency across the entire continuum of care.

Case Manager

Personalized Support with PersonalMed Case Manager

Managing complex patient needs requires a hands-on approach, and PersonalMed Case Manager is here to help. Our dedicated case management solution ensures seamless coordination between patients, providers, pharmacies, and health plans. By offering personalized support, proactive medication adherence strategies, and real-time communication, we help reduce gaps in care and improve health outcomes. With a focus on efficiency and patient engagement, PersonalMed Case Manager simplifies the healthcare journey—allowing benefits managers to enhance service quality while optimizing costs.

Pharmacy Solutions

Manage Compounds While Controlling Costs

Every patient’s healthcare journey is unique. PersonalMed Benefits Manager helps PBMs like you inform and support every step of a patient’s personalized medication-access experience through the best of today’s technology.  

PBM Members gain access to the PersonalMed suite of applications designed for and built in the cloud. 

Prior Authorization Management ​

AI-Powered Prior Authorization with PersonalMed RxManager

PersonalMed RxManager streamlines the prior authorization process with advanced AI automation, reducing delays and administrative burdens. Our intelligent system quickly verifies medication approvals, ensuring compliance while accelerating patient access to prescribed therapies. By minimizing manual intervention, RxManager enhances efficiency, reduces costs, and improves the overall patient experience. With real-time decision-making and seamless integration into existing workflows, benefits managers can ensure faster, more accurate approvals—leading to better health outcomes and reduced operational strain.

Formulary Management

PersonalMed Formulary offers compounders access to the PersonalMed repository of compounding formulas. 

Benefit from a complete review of clinical and pharmaceutical literature to support each formula. All formulations undergo extensive testing for correct preparation and procedure. 

Monitor prescribing platforms and prescriber-level utilization management. 

Medical Solutions

FWA Prevention

AI-Driven FWA Prevention for Smarter Healthcare Management

PersonalMed, powered by 4L Data Intelligence, provides a comprehensive Fraud, Waste, and Abuse (FWA) prevention solution that ensures the integrity of your healthcare network. Our advanced AI-driven platform utilizes Provider Integrity Edits to verify legitimacy, Adaptive Claim Edits to catch irregularities in real-time, and Billing Behavior Analytics to identify patterns of waste or abuse. Additionally, Provider Scheme Analytics proactively detects fraudulent activities before they impact your organization. By automating fraud detection and streamlining compliance, PersonalMed helps benefits managers reduce financial risk, enhance operational efficiency, and maintain trust in their provider networks.

Non-Emergency Medical Transport

Seamless Non-Emergency Medical Transport with PersonalMed Transport

PersonalMed Transport, powered by TrekIt, simplifies non-emergency medical transportation by handling patient eligibility, scheduling, and prior authorizations in one seamless platform. Our automated solution ensures that patients get to their appointments on time while reducing administrative burdens for benefits managers. By integrating real-time eligibility verification and AI-driven scheduling, PersonalMed Transport streamlines coordination between healthcare providers and transportation services, improving access to care and reducing missed appointments. Ensure reliable, hassle-free transport for your members while optimizing efficiency and cost-effectiveness.