Clear Options Services Description


Client Responsibilities

Truveris relies on Client to provide data and information, as a prerequisite to perform the services at the highest quality. Truveris may obtain such data on behalf of the Client, with reasonable assistance from Client, in order to perform the services. If Truveris is not provided or unable to obtain the necessary information, partial or in whole, accuracy of results may be affected.

The following are required information to perform Clear Options Rx powered by the Truveris Marketplace® services, in order of importance from highest to lowest priority:

  • Current claims data spanning twelve (12) consecutive months;
  • Completed Census file, (members enrolled)
  • Plan Design documents
  • Completion of Truveris provided questionnaires;
  • Other additional information, as necessary;

The following information is required to perform Ongoing Reporting Services, which includes ClearGuard, in order of importance from highest to lowest:

  • Ongoing claims data, minimum required fields to be provided;
  • PBM service agreement;
  • Plan documentation;
  • Price lists;
  • Other additional information, as necessary;

In the event any information becomes outdated, Client is responsible to notify in a commercially reasonable amount of time, but no less than five (5) business days after the information becomes outdated and provide any updated information immediately.

During the Clear Options Rx powered by the Truveris Marketplace® evaluation and award process, the Truveris team takes a data-led approach to secure the best pricing terms by driving transparency and creating a dynamic competitive bidding environment. Truveris will assess the RFP parameters, data and pricing term requirements, and share timelines with the Client.  The Client’s existing information will be configured onto the platform and Truveris will provide a Savings Analysis Report. Truveris will award the applicable Administrator following written authorization by the Client.

Ongoing reporting services includes ClearGuard , a fully automated 100% claim-by-claim review to detect discrepancies and uncover actionable optimization opportunities throughout the plan lifecycle.  The Client will receive quarterly and/or annual reports along with recommendations around actionable insights.

Truveris’ engagement services may also include oneRx, the only patient-facing portable prescription management service that helps members find the lowest out-of-pocket drug prices comparing their insurance to competitive discount cards leading to better adherence and outcomes.