🗂️ Navigation

Prodigy Health

A new standard in pharmacy benefits.

Visit Website →

Overview

Prodigy Health is a Pharmacy Benefit Manager (PBM) that leverages technology to manage prescription drug benefits for self-funded employers. A core part of their service is drug utilization management, which includes formulary management, prior authorization, and retrospective DUR. They analyze claims data to identify opportunities for cost savings and improved clinical outcomes, such as promoting generic substitution, identifying therapeutic duplication, or managing high-cost specialty drugs.

✨ Key Features

  • Formulary management
  • Prior authorization services
  • Retrospective Drug Utilization Review
  • Specialty medication management
  • Claims processing and analytics
  • Rebate management

🎯 Use Cases (3)

Managing the pharmacy benefit for a self-funded employer. Conducting retrospective reviews of drug claims to identify waste or inappropriate prescribing. Implementing clinical programs to manage specialty drug costs.

✅ Best For

  • Serving as the PBM for employer groups and health plans.

💡 Check With Vendor

Verify these considerations match your specific requirements:

  • Direct use by a provider for e-prescribing (it's a payer-side tool).

💻 Platforms

Web

🔌 Integrations

Health Plan Systems Data Warehouses

🛟 Support Options

  • ✓ Email Support
  • ✓ Phone Support
  • ✓ Dedicated Support (Enterprise tier)

🔒 Compliance & Security

✓ HIPAA ✓ BAA Available ✓ SSO

💰 Pricing

Contact for pricing
Visit Prodigy Health Website →