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.

EHO is a technology-driven Prescription Claims Processing Company with its state-of-the-art claims processing center, live pharmacist help-desk, and administrative/management offices all located in Belton, Texas.

We partner with our clients to deliver premium services, provide exceptional client service and custom-tailored solutions for your hospice needs.
CMS Required Reporting CR 8358
EHO will provide our customers with the detailed data in a secured environment. Hospice clients will have access to their data files through our secured EHO Web Portal - available as both automated and on-demand.
Real-time Capabilities
Examples include Prescription Claims Processing, Pharmacy Messaging and Prospective Drug Utilization Review for Patient Safety.
Online Report Access
Brief, Comprehensive, Concise and Relevant Reports & Analyses. EHO also customizes reports and analyses to define, design and develop economies.
Rebate Collection
Client Validations and Applications for Direct-to-Hospice Rebates and - Hospice gets all the rebate.
Patient Enrollment Made Simple
Optional enrollment and maintenance processes include verbal, fax and online.
National Pharmacy Network
More than 56,000 Chain and Independent pharmacies
Client and Caregiver Communications
Circulation of What's Up? communications of Hospice-relevant information

Reduce Your Drug Cost-Per-Patient-Per-Day

  • Controlling and limiting your prescription costs through:
    • Universal discounted pricing & real-time point-of-sale utilization controls;
    • Custom fill limitations to reduce waste and abuse
    • Non-capitated benefit design - (Unlike capitated or per diem programs that incorporate built-in fudge factors to guarantee PBM profits, with EHO you only pay for what you get - and you control your prescription benefit design.)
    • Customized cost-saving therapeutic formularies and comfort kits
  • Simplifying your accounting & saving labor (You cut only 2 checks per month!)
  • Detailing patient-specific utilization data with concise executive summaries
  • Dedicating a Hospice phone, e-mail and web services for paperless transfer of patient data

EHO's large client base & "no mail-order" philosophy enhance local pharmacy access and price leveraging that favor all hospice Clients - small, large or remote satellites.

Use EHO's solutions to get the most value from your drug benefit. We help you do it with the most complete family of IT management solutions. All our operations are based on proven processes and industry best practices.

Custom Design
All benefit programs are customized to fit the Client's needs.
No Outsourcing
All administrative, claims processing and technical solutions are performed in-house. Prescription claims are processed with proprietary systems and software applications.
Specialized teams of Account Management Representatives and Pharmacists. Each Client will work with its own dedicated staff. Many of our Clients have worked with us for more than 10 years and have become like part of our family.
Real-Time Updates
Clients are allowed complete access to all aspects of their benefits design including updating their employee census or printing any of our management reports.
On-line Real Time Adjudication
With programs supporting formulary, step therapy protocols, complex plan benefit structures, etc.
National Pharmacy Network
More than 56,000 Chain and independent pharmacies.
MAC Generic Pricing
The most aggressive MAC generic pricing in the industry.
On-line Report Access
All of our clients have online access to all their employee prescription history, real time transaction data.
24/7 Live Help Desk
24 hour access to a real person. A member services team trained to provide the highest levels of customer service. No confusing touch-tone menus. When you call EliteCare, your call is answered by a live representative at our U.S.-based Central HelpDesk.

Maximum Benefit Design Flexibility

Unlike traditional PBMs, EHO's plan changes can be executed in real-time. Our experienced staff is readily available to assist clients at every phase of the plan design, monitoring and adjustment phases, so they can easily implement plan designs that will have a positive impact on their bottom line. Features include:

  • Plan Analysis, Design and Implementation - allowing clients as much or as little control over the process as desired. Our seasoned team ensures seamless implementation and timely launch
  • Customized Benefit Structures - providing exceptional control down to the patient level, allowing for inclusions and exclusions for greater plan flexibility, accommodating even the most complex plan design
  • Automated Therapeutic Protocols TheraMac™ to more effectively execute plan-specific step protocols and reduce cost of interventions
  • Brand Interchanges - allowing for exceptions to ensure appropriate generic substitution and therapeutic interchange
  • Mail order options - allowing clients the option to offer mail order delivery, in an effort to save enrollees money and increase payer profits

EHO's simple approach is to provide unparalleled claims payment accuracy in a processing environment where plan updates and benefit parameters are updated in a matter of hours, not weeks or even months.