US-Rx Care Uses Astera to Efficiently Manage High-volume Data File Exchanges with Multiple Third Parties.
Since 2007, US-Rx Care has been a leader in pharmacy benefits and risk management, providing fiduciary services to self-insured employees, union trust funds, and health plans. With over 30 years of experience, the company has consistently delivered significant reductions in pharmacy benefit spend (more than 30%-50%) and helped insurance plans achieve higher HEDIS/Stars quality scores.
US-Rx Care engages in file transfers encompassing millions of pharmacy claims and member eligibility records in EDI format monthly. They faced challenges in managing over 1,000 individual workflows for custom files shared with third parties and internal use. Accurate and efficient data exchange was crucial for their operations.
US-Rx Care relied on a third-party vendor for their data file exchange processes. However, accuracy and consistency became recurring issues.
To address their needs, US-Rx Care sought a solution that would enable them to compile, send, receive, and decrypt EDI files securely. After evaluating several products on the market, US-Rx Care turned to Astera.
These solutions leverage the power of EDI functionality and an integration ETL engine, enabling US-Rx Care to extract, transform, and generate EDI files within a single platform. This significantly decreased their reliance on third-party applications and alleviated the challenges associated with managing and maintaining numerous isolated systems.
By adopting Astera, US-Rx Care achieved significant improvements in their data workflows, empowering non-technical staff to manage the entire process from end to end while reducing reliance on external resources.
“The ability to allow non-developer staff to set up the workflows and manage the whole process from end to end was the most important goal that we achieved. Overall, the system is reasonably intuitive though does require some learning to get up to speed and to leverage the many flexible features the system has to offer. The support team has been valuable to provide suggestions and evaluate possibly efficiencies we can take advantage of.”