Are You Getting Superior Customer Service from Your PBM?

Posted by Navitus Health Solutions on Oct 1, 2021 6:25:31 PM

As a plan sponsor, getting the level of customer service you deserve shouldn’t be a tradeoff for your drug benefit.


Excellent customer service will never go out of style. And plan sponsors should expect it from their pharmacy benefit manager (PBM) so that they can deliver a high-quality, affordable drug benefit for their members. In addition to lowering plan costs and helping to improve health outcomes, your PBM should deliver on your customer expectations. In turn, this builds value and trust.

Going Above and Beyond for Customers

Partnering with a PBM that aligns with your goals makes for a successful relationship that drives satisfaction for you and your members.

At Lumicera Health Services, a wholly-owned subsidiary of Navitus, superior customer service is at the heart of everything we do. In 2020, clients gave us a 99% overall satisfaction rate. We also scored 4.9 out of 5 across the board for “Timeliness and condition of medication delivery,” “Accuracy of order,” “Knowledge of patient care specialist” and “Overall satisfaction with Lumicera Services.”


We continually strive to help all our customers because we know that each person we touch matters. And our industry-high Net Promoter Score (measures customer satisfaction and loyalty) of 72 is further evidence.

Clients should expect their members receive high-touch support to support positive health outcomes.

As part of our Medication Therapy Management (MTM) program, our Clinical Engagement Center team reaches out to members and their providers to provide evidence-based recommendations to members and their clinicians that play a key role in optimizing health outcomes. Below is an example of one member's experience shared by a Customer Care Supervisor:

"Member called in to ask about the MTM program letter they received. They have a medical condition that makes it difficult to speak and it can take some time to get through what they need to say, often leading to people cutting them off and/or trying  to finish their sentences. However in this experience,  the Navitus agent was incredibly patient and waited for them to finish speaking before providing the exact information needed. They shared that the assistance the Customer Care Specialist provided was the best customer service experience they had ever had! And the specialist had such a positive and infectious attitude throughout the whole call that it just made their day!"

Health care providers often communicate with PBM call centers and should interact with knowledgeable staff and get timely responses.

"Navitus maintains impeccable customer service for pharmacies. When I call for patient information, I am never on hold longer than a minute or two – and often less than that. On several occasions, I have called other Pharmacy Benefit Managers and found the pharmacy support staff confused about providing even simple support such as vacation overrides. The Customer Care staff at Navitus easily provides the information I need or quickly escalates the question to someone who knows the answer. I have found this particularly helpful after 7 p.m., when our pharmacy is particularly busy."

- Pharmacist

“Navitus was great! They knew exactly what they were doing. I didn't have to explain what I needed. They knew exactly what I needed. This is the best customer service that I've received in my 25 years working in a pharmacy!”

- Pharmacist

Members should feel supported when they contact your PBM to resolve issues, which helps minimize calls to your human resources department.

"A member had called in to get a vacation override on two medications. They were having trouble filling one particular medication that the pharmacy did not have access to and would have to special order. They did not have the time to wait. The member said that the Navitus customer care agent had gone above and beyond by calling an alternate pharmacy to confirm that they have access to the medication and would have it ready in an hour. They were incredibly impressed by the level of service the representative provided today."

-  Navitus Customer Care Supervisor

Get the Level of Service You Deserve

The pharmacy benefit landscape is complex. That is why it is paramount to partner with a PBM committed to providing solutions to the challenges you and your members face. And delivering superior customer service should be at the core of your PBM to help you maximize the value of your drug benefit plan. Navitus Health Solutions is URAC accredited, earned a 4.5 out of 5 Overall CMS STAR rating for its Medicare Employer Group Waiver Plan (EGWP)*  for the 2021 plan year and achieves a 100% satisfaction score for implementations.

We stand ready to serve you and provide the level of customer service you deserve. To learn more about how we can help, email today.

Want more information? Read this LinkedIn article titled The Importance of Stellar Customer Service in a Trusted PBM Relationship.

*Medicare evaluates plans based on a 5-star rating system. Star Ratings are calculated each year and may change from one year to the next.


Topics: Member

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