Located in the Belton, Texas, EHO is a prescription claims processor that since 1993 has focused on administering prescription claims for health maintenance organizations, third party administrators, preferred provider organizations, pharmacy benefits management companies, employers, hospice programs, workers compensation programs, patient assistance programs (state, county, municipal, MHMR, etc.) and fraternal groups. Specifically, EHO helps its clients design pharmacy plans, implement the plan, perform ongoing administration and troubleshoot any issues that arise.
EHO's business model focuses on constantly striving to control costs while providing excellent member service, advice and reporting functions. EHO specializes in administering the prescription benefit plans with a need to both control prescription plan costs and provide employees with a valuable, much appreciated benefit.
Model for Success
EHO provides an unequalled level of service while controlling costs to its end users by employing the following simple business practices:
- Strong Customer Service via One Point of Contact. Having one highly knowledgeable and well-trained point of contact for each client provides easy access and fast response to customer needs.
- Personalized Service. Calls are always answered by a live customer service manager. Both clients and patients never have to navigate the maze of a complicated voice mail system in order to get help. Patients almost always speak to the same customer service manager who knows the patient's history and acts as their advocate. This provides continuity of service to the patient, alleviates miscommunications, avoids delay in the process and promotes issue resolution. All of the client service managers are cross trained to ensure continuity throughout the client base.
- Quick Turn Around. EHO quickly and efficiently investigates all prescription related problems, thereby reducing the amount of time it takes for patients to get their issue resolved. Issues are often resolved while the patient is still at the pharmacy or on the phone; otherwise within twenty-four hours.
- Human Intervention. EHO's policy is to review a significantly larger number of claims than others by establishing a low dollar threshold amount which triggers standard review. In addition to clinical considerations, this allows EHO to apply human logic to the adjudication process. Human intervention allows EHO to identify issues that a system might ignore, helping reduce cost to the plan while improving patient outcomes. EHO keeps an extensive notes database that tracks actions taken on every member and process.
- Low Costs EHO believes in taking advantage of every opportunity for saving money for its clients, no matter how small each incident may be. EHO is known as an industry leader in providing the lowest prescription cost to its providers.
- Coordination of Benefits By actively monitoring coordination of pharmaceutical benefits for those patients with more than one source of coverage, EHO reduces costs for its clients.
- Immediate updates. EHO's live 24/7 help desk actively makes changes on the fly. There is no time delay adding new employees or terminating employees. While our clients are requesting changes we can make the changes while we are on the phone with them.
- Flexible Plan Design. Unlike large insurers and other competitors, EHO works with each client to develop a unique benefit structure and plan design that can rein in costs while satisfying the healthcare needs of our client's employees.