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Coverage and Claims
Pharmacy Outreach Program
Our pharmacy outreach programs provide you with information about your patient's pharmaceutical treatment patterns and options.
Our pharmacy outreach programs provide you with information about your patient's pharmaceutical treatment patterns and options. These programs can help you improve outcomes and avoid unintended drug consequences.
How does Pharmacy Outreach work?
If you have patients who are Cigna HealthcareSM customers and who meet the criteria for a pharmacy outreach program, we'll send you a notification letter with the patient's clinical history. A Cigna Pharmacy Management® pharmacist may call you to discuss the patient's information.
Examples and improvements
These pharmacy outcome improvement programs are just three examples of the sort of outreach your patients might benefit from.
Cholesterol treatment to goal
People who reduce their LDL cholesterol levels may also lower their risk of heart attack. We use medical, pharmacy and laboratory claims data to help identify members who are taking lipotropic medications, but who may not be reaching their National Cholesterol Education Program (NCEP) LDL cholesterol targets.
When you talk to your patients, stress the importance of taking medications as prescribed, as well as the importance of regular cholesterol testing through labs that participate in their Cigna Healthcare plan's network.
The National Heart, Lung, and Blood Institute asthma care guidelines recommend controller therapy for most people diagnosed with asthma.
To help prevent asthma complications, we help identify members who have frequently filled prescriptions for short-acting beta-agonist inhalers, but have not filled prescriptions for controller therapy. We also provide you with customer information to help you have an enhanced treatment picture. Our approach has had positive results.
Talk with your patients about helping to control their asthma by adding controller therapy to short-acting, beta-agonist inhalers when indicated.
This improvement opportunity integrates data from medical, behavioral and pharmaceutical services to help identify opportunities to improve member adherence to prescribed treatment. The data identifies opportunities for improvements measured by diagnosis, length of therapy and medication waste.
Talk with your patients about the importance of adhering to their prescribed course of treatment.
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Individual and family medical and dental insurance plans are insured by Cigna Health and Life Insurance Company (CHLIC), Cigna HealthCare of Arizona, Inc., Cigna HealthCare of Illinois, Inc., Cigna HealthCare of Georgia, Inc., Cigna HealthCare of North Carolina, Inc., Cigna HealthCare of South Carolina, Inc., and Cigna HealthCare of Texas, Inc. Group health insurance and health benefit plans are insured or administered by CHLIC, Connecticut General Life Insurance Company (CGLIC), or their affiliates (see a listing of the legal entities that insure or administer group HMO, dental HMO, and other products or services in your state). Accidental Injury, Critical Illness, and Hospital Care plans or insurance policies are distributed exclusively by or through operating subsidiaries of The Cigna Group Corporation, are administered by Cigna Health and Life Insurance Company, and are insured by either (i) Cigna Health and Life Insurance Company (Bloomfield, CT); (ii) Life Insurance Company of North America (“LINA”) (Philadelphia, PA); or (iii) New York Life Group Insurance Company of NY (“NYLGICNY”) (New York, NY), formerly known as Cigna Life Insurance Company of New York. The Cigna Healthcare name, logo, and other Cigna Healthcare marks are owned by The Cigna Group Intellectual Property, Inc. LINA and NYLGICNY are not affiliates of Cigna Healthcare.
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