By 2020, specialty drugs in the pipeline will comprise 25% of the projected overall pharmacy benefit growth.

Top specialty drug category driving spending  in 2019-2020


Business Consulting

With our consulting expertise, healthcare organizations can manage, optimize and transform their businesses to new, efficient business models.

  • Credentialing
  • Network Development
  • Provider Services
  • Member Services

Clinical Services

  • Pre-authorization services based on CMS Local Coverage Determination and Insurance Medical Policies.
  • Medical Necessity screening.
  • For Specialty Pharmacy our clinical team will conduct a telephone interview with the patient to validate that the medication was administered as directed by physician (Adherence Monitoring).
  • Quality management and Outcomes (subjective and objective measures).

Claims Services

  • Prepayment Reviews
  • Post Payments Review and Recovery process
  • Reimbursement Policy
  • Claims audit
  • Claims Processing
  • Claims payment
  • Benefits management
  • Pre-existing benefit exclusion Management


We acknowledge that training is vital in any project success. That’s why we will train and guide thru the implementation process our client’s team members as part of our service.



9675 NW 117 Ave, Suite 115, Medley, FL 33178

Call Us

Miami: 786.708.8394
Puerto Rico: 787.361.5066


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