Golden Triangle Specialty Network, LLC. offers a highly recognized Specialty Pharmacy Cost Containment Program. Working with our in-house Pharmacist allows for better clinical review, and better understanding of claims. We are a preferred vendor for many of the largest stop loss carriers in the U.S. Golden Triangle always offers discounts secured by provider sign-off.
Golden Triangle’s Services Include
- Free case review by in-house Pharmacist (Pharm. D. / RPh) and Nurse
- No changes to your plan document and benefits
- No balance billing to patients
- Provider sign-off so it’s always secure
- Assistance in understanding complex cases
- Fast response
Specialty Pharmacy Case Studies
Genetic Orphan Drug: Stop Loss carrier referred an ongoing $1.2 million per year Orphan Drug case involving lifetime care. With no discount on the drug and an exclusive market provider they needed help. GTSN negotiated a deep discount saving the employer group over $500,000 per year.
MS Drug: TPA referred an ongoing case with an existing 20% discount. Provider had dramatically increased the MS drug charges the prior year, but they were unable to increase the discount. GTSN worked with the provider to obtain a 40% discount and will be able to revisit again if charges increase over time.
Cancer Drug: Client asked us to look at a cancer case receiving a unique and expensive drug. Our Pharmacist found the manufacturer had a financial assistance program that had not been contacted yet and it was determined the drug would be 100% covered for the client’s member. The plan saved hundreds of thousands of dollars and GTSN did not charge them a fee.
Billing Error: A new client referred paid claims for a case to GTSN looking for better savings. Our pharmacist found the discount was good, but the dose billed would have killed the patient. GTSN worked with the provider to correct the $60,000+ per month billing error over a four month period saving the group over $240,000. The corrected claims were sent to the TPA for a refund request. The client only paid a fee on the claims correction, not the go forward “savings”.