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TriNet

Third party contract negotiation and management for the needs of today’s independent community pharmacies.

Contract with confidence.

Our experts make managing the third party side of your business easier. We’re also here to provide support and guidance on all third party issues when needed.


TriNet works hard with third parties to help us get the reimbursement we deserve. The staff goes out of their way to help us. They are all very knowledgeable and very friendly. TriNet also keeps us up-to-date with information on insurance company and third party changes that we need to know. 

Miracle Petrino
MD Compounding Pharmacy
Boardman, Ohio



Looking out for you.

We don’t just sign contracts. We make sure PBM contracts meet a thorough set of requirements that work for your business. Our legal experts examine each contract and negotiate the best terms and conditions possible. We look for:

  • Reimbursement rates
  • Cash card requirements
  • Payment frequency
  • Recoupment process/overpayment clauses
  • Contract compliance
  • Network participation for pharmacies
  • Audit clauses

The support you deserve.

We’re always available to answer questions, solve issues and provide tips and educational information to help your pharmacy succeed in the third party business.

 


 

Quality measures with EQuIPP.

Now you can see how you score on the quality measures that matter to your business. TriNet partners with EQuIPP™, a recognized tool for pharmacy quality measurement and benchmarking, to provide pharmacies with a dashboard of business intelligence tools that illustrate their performance. You’ll know how your pharmacy measures up on the Medicare Part D Star Rating program, and we’ll give you tips on how to improve.

 


 Features of TriNet:

Audit support
Stay ahead of a potential third party audit with help from TriNet. We provide tips, guides and checklists to help you prepare. We also provide assistance during an audit.

Communications and resources
We regularly provide guides, how-tos, instructions, and updates to help you stay on top of PBM plan changes, industry regulations and more. From upcoming changes on Medicare Part D to fraud, waste and abuse training and attestations, we keep you informed on the information you need to know.

Cost analysis
We’re able to more accurately determine proper reimbursement rates and better negotiate third party contracts by analyzing the cost data available through the PBA Health warehouse.

Legislative advocacy
TriNet supports national and state legislation that positively influences independent community pharmacies.

MAC appeals
When a claim reimburses incorrectly or below cost, we’ll file a MAC appeal for you. We believe that every appeal (even if it isn’t accepted) helps build the case for appropriate reimbursement. We also perform automatic MAC claim analysis to supplement these appeals.

PBM issue resolution
It’s not just about submitting requests; we actively work to solve your issue. You can count on support for contract questions, pharmaceutical claims that won’t process, clarification on network participation, cash discount card issues and more.

Quality measurements
Understand (and improve) your pharmacy’s performance on Star Ratings with our business intelligence tools through EQuIPP.

Get started

Contact us for information or to learn more about TriNet.