Services: Network Information

SWPS contracts for the nationwide pharmacy networks with our claims processing partner. Approximately 60,000 pharmacies are available nationwide.

Three nationwide retail networks

SWPS offers three nationwide retail networks. The claims processing system looks for the deepest discounted network first, then “cascades” to the remaining networks until the dispensing pharmacy is found. This process takes a fraction of a second.

SWPS typically proposes clients “blend” the three networks for ease of access to patients and cost containment for the plan, but each client can define the structure of their network as one, two, or all three.

Custom "preferred pharmacy networks"

SWPS also creates custom “preferred pharmacy networks” in defined geographic areas for clients. The preferred pharmacy network allows patients to receive maintenance quantities (i.e. 90 day supplies) of medications at these selected local retail pharmacies. This is very well received by the member and the pharmacy, keeping the money in the local economy as well. This also translates into cost containment for the plan, as all claims filled at these selected pharmacies dispense at deeper discounted rates.

The generic contracted rate for all the retail networks is aggressive utilizing the lesser of AWP logic or MAC for all three networks. The SWPS MAC list provides a Generic Effective Rate (GER) superior to national averages.

Quotes are available upon request. Call us at 800-728-7947 for more information.

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