Wauwatosa-based Tricast Inc. has introduced a new web-based software tool, called Reveal 2.0, that allows health plan administrators to get real-time pharmacy data.
Tricast is a pharmacy data analytics company that offers consulting and tools to help clients make decisions to lower health care costs and manage pharmacy benefit programs.
Using Reveal 2.0, clients can monitor pricing, process, and formulary and rebate adherence. The product, which has a patent pending, also helps users stay in compliance with Centers for Medicare and Medicaid Services oversight requirements, including automated reject analysis and comparisons of source to PDE claims.
“We’ve baked all our knowledge into a product that delivers real-time surveillance and analytics (both retrospective and predictive) for comprehensive pharmacy benefit oversight. There’s really nothing else like it in our industry,” said TRICAST President Greg Rucinski.
This is the first Tricast product that uses software as a service, or licensed subscription software that is centrally hosted.
“Applying a SaaS model in the health care industry has the potential to significantly reduce our clients’ IT support costs as well as allowing Reveal to grow with the client without incurring additional IT capital expenditures,” said Chris Favero, director of infrastructure.
It’s a switch for the 15-year-old company, from internal to external software use, Rucinski said.
“We’re particularly looking at rejected claims,” he said. “CMS is very concerned that a subscriber could walk out of a pharmacy without their medications. They don’t want someone to not get a pharmaceutical if one’s available and it’s approved on the formulary, and they want the result in 48 hours.”
The software can also be used to track fraud, waste and abuse in real time.
“This real time monitoring of price and process really accrues to the benefit of anyone who takes risks in the medical field,” Rucinski said. “We provide that third party oversight that the government wants all of these plans to adhere to, but we provide it as a software.”
Tricast introduced the product about three months ago and is in the process of converting five existing clients and enrolling two new health plans on the software.
