Challenge

• Member filling pain medication at a cost of $16,000/month
• Questions about why the provider was using such expensive pain medication and was there an alternative

Solution 

• Initiated conversations with the provider and carrier to discuss alternative medications
• Provider agreed the prescription may not be necessary
• Member is off the medication and going through detox therapy for opioid addiction

Client Win

• $16,000/month cost was discontinued on behalf of the client