The Importance of Stellar Customer Service in a Trusted PBM Relationship

Posted by Navitus Health Solutions on 11/19/20 7:00 AM

Reducing spend is important, but shouldn't be your only priority when selecting a PBM. Chief Growth Officer Byron Mickle explains why strong customer service from the get-go is key to a successful partnership.
Plan sponsors that have worked with transparent PBMs know firsthand that they can be counted on to provide high-quality and affordable pharmacy benefits for their members. In addition to lowering drug costs and improving health care quality, customer service has grown to be equally as vital when it comes to selecting a PBM and ensuring members receive the care they need.

The Importance of Stellar Customer Service in a Trusted PBM Relationship

Strong customer service builds trust between a plan sponsor and its PBM, improves the member experience, and ensures both plan sponsors and their members feel confident in their care. Investing in customized support, user-friendly approaches and continuous communications makes managing pharmacy benefits easier for everyone.

From cost savings and especially peace-of-mind, I’ve seen the value of customer service go a long way for plan sponsors and their members. Here are a few ways you can identify a PBM partner that is ‘All-In’ on its customer service approach:


Whether an organization has just started to think about a new PBM partner or has already committed to making a change, transitioning the pharmacy benefit offering can cause worry and uncertainty. For example, members might question if their medications will be covered, how much they’ll cost, or if they can continue using their current pharmacy. The ability to quickly find key pieces of information like this in a manner that is most comfortable for each member—such as through an app, online portal, or live call center—is essential to building trust and creating a smooth transition and onboarding experience.

Your PBM must offer personalized, multi-channel engagement using simple communications that are easy to understand and act on. This should start prior to day one of the effective date through clear, concise onboarding materials that introduce members to their benefit and help them understand how to use it. Smartphone apps and online portals pick up where these leave off to answer the members questions anytime, anywhere and on any device. The customer service team should be standing by to provide members with clarity on their costs and savings opportunities, offer guidance, and establish peace of mind that their expertise is available to support members every day.

Accessible and Focused on You

A PBM should be accessible 24/7, no matter the size of your organization. Whether you have thousands of members or just a few hundred, a PBM should always prioritize your organization and its members.

A plan sponsor may only have a few internal employees dedicated to members who have questions or concerns about their pharmacy benefits, so a PBM’s customer service team should act as an extension of your own.

Indicators of superior PBM customer service include little to no wait time for phone calls, and questions or issues that are addressed within the span of only one call or email. A PBM should be able to resolve most issues or concerns with plan members quickly, instead of sending them down a redundant path to their pharmacy, prescriber, HR reps or other contacts. Finally, a PBM should be willing to meet with plan sponsors on a regular basis and provide suggestions for how to improve processes, reduce costs and improve member health. Instead of promoting alternative agendas such as encouraging expensive medication use that may provide a higher rebate or pushing members toward mail-order or their own specialty pharmacy, meetings and communications should be entirely focused on what the PBM can do to better serve your pharmacy objectives and your plan members.

While reducing spend is often top of mind, strong customer service should also be a priority when selecting a PBM. Accessibility and personalized focus from the get-go is the key ingredient to a successful partnership that builds trust and achieves results.

If you’re interested in how to tell whether a PBM is truly transparent or just using “transparency” as a buzzword, I encourage you to download our e-book, PBM Transparency and How it Impacts Real Cost Savings.


Navitus Byron Mickle


written by bYRON mICKLE

Byron Mickle is the Chief Growth Officer at Navitus, where he oversees and provides executive leadership to the Sales and Marketing departments. With an intimate understanding of the different PBM models and broad industry experience, Byron provides unique insight on the PBM landscape and its influence on Rx costs. 



Topics: Insider

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