
2 minute read
First MCO PBM Highlights
from First MCO PBM
by FirstMCO

FMCO® is a registered trademark of
First Managed Care Option, Inc.
We Do More so That You Don’t Pay More
Our overall approach to pharmacy management eliminates costs from unnecessary medications. This ensures that you pay for what your patients need, but only for what they need.
Clinical Oversight
Prescriptions are reviewed to ensure they are medically necessary, appropriate for the injury claimed and at a suitable dosage. We also monitor for:
◊ High-risk physicians/patients
◊ Early or frequent renewals
◊ Medication not prescribed by approved provider
Point of Service Cost Controls
◊ Generic medication is dispensed unless Brand is required by physician
◊ All high-cost prescriptions require Case Manager approval
◊ Medication outside of the formulary is automatically rejected
Network Benefits
◊ A list of network pharmacies is issued during 1st Report
◊ Realtime adjudication before drug is dispensed
◊ Mail order delivery available in most cases

We have over 45,000 pharmacies in our network nationwide
We have nurses available 24/7 to:
• Contact physicians who prescribe brand medications when a generic is available
• Respond to patient questions or concerns
• Authorize medication off hours
• Pharmacy card is emailed or texted to the patient before the intake call is complete.
Catching that "1st Fill"

*In 50% of Workers’ Compensation claims, the 1st prescription filled is the only one.
• Pharmacy cards can be fully branded or co-branded

Claimants Receive a Network Provider Panel Along with Their Digital Card.

(973) 257.5200
www.firstmco.com
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