Prime Therapeutics
Encyclopedia
Prime Therapeutics LLC is
a Pharmacy Benefit Manager (PBM) headquartered in Eagan, Minnesota
. The company is privately held by organizations representing 12 Blue Cross and Blue Shield (BCBS) plans in Alabama, Florida, Illinois, Kansas, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Oklahoma, Texas and Wyoming.
Prime Therapeutics operates contact centers in Omaha, Nebraska
and Irving, Texas
and operates two mail service pharmacies in Irving, Texas
, and Albuquerque, New Mexico
. The company also has offices in Bloomington, MN, Chicago, IL, Jacksonville, Florida
, Hoover, Alabama
, Pittsburgh, PA and Washington, D.C.
Prime Therapeutics is the largest privately held PBM in the United States that does not own any chain pharmacy stores and whose stakeholders are Health Care Service Corporation
, Blue Cross and Blue Shield of Alabama
, Blue Cross and Blue Shield of Minnesota, Blue Cross and Blue Shield of Nebraska, Blue Cross and Blue Shield of Kansas, Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Florida, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Montana. Its major competition comes from companies such as Caremark Rx
, Medco Health Solutions
, Express Scripts Incorporated
, and Catalyst Rx. Prime Therapeutics covers nearly 19 million lives across 18 different Blue Cross and Blue Shield Plans, 184,000 employer groups.
Prime is also one of the regional processors for Medicare Part D for the Blue Cross Blue Shield plans that own it: HISC (a subsidiary for Health Care Service Corporation
), the Northern Plains Alliance (BCBS of Minnesota, North Dakota, Noridian a BCBSND company, Nebraska, Wellmark, Wyoming and Montana) and Blue Cross Blue Shield of Florida. With BCBS Minnesota it also includes South Country Health Alliance, PrimeWest Health System, the state sponsored health plan called Pre-Paid Health and First Plan of Minnesota.
Prime also provides specialty pharmacy management to its Blue Cross and Blue Shield clients through its Triessent program. The Triessent program provides safe and efficient medication delivery, personalized member support, and a comprehensive set of tools for managing specialty drug spend under both the pharmacy and medical benefit.
Source: Prime Therapeutics
and support the following messaging protocols via the latest NCPDP SCRIPT
standard on the Surescripts network:
Electronic Prescriptions (NEWRX)
Electronic Refill Requests (REFREQ/REFRES)
Medication History Requests (RXHREQ/RXHRES)
Prime Therapeutics as a PBM also supports the ANSI X12 270/271 protocol for formulary and eligibility requests for all of its clients.
a Pharmacy Benefit Manager (PBM) headquartered in Eagan, Minnesota
Eagan, Minnesota
Eagan is a city south of Saint Paul in Dakota County in the U.S. state of Minnesota. The city lies on the south bank of the Minnesota River, upstream from the confluence with the Mississippi River. Eagan and nearby suburbs form the southern portion of Minneapolis-St. Paul, the fifteenth largest...
. The company is privately held by organizations representing 12 Blue Cross and Blue Shield (BCBS) plans in Alabama, Florida, Illinois, Kansas, Minnesota, Montana, Nebraska, New Mexico, North Dakota, Oklahoma, Texas and Wyoming.
Prime Therapeutics operates contact centers in Omaha, Nebraska
Omaha, Nebraska
Omaha is the largest city in the state of Nebraska, United States, and is the county seat of Douglas County. It is located in the Midwestern United States on the Missouri River, about 20 miles north of the mouth of the Platte River...
and Irving, Texas
Irving, Texas
Irving is a city located in the U.S. state of Texas within Dallas County. According to the 2010 U.S. Census, the city population was 216,290. Irving is within the Dallas–Plano–Irving metropolitan division of the Dallas–Fort Worth–Arlington metropolitan area, designated...
and operates two mail service pharmacies in Irving, Texas
Irving, Texas
Irving is a city located in the U.S. state of Texas within Dallas County. According to the 2010 U.S. Census, the city population was 216,290. Irving is within the Dallas–Plano–Irving metropolitan division of the Dallas–Fort Worth–Arlington metropolitan area, designated...
, and Albuquerque, New Mexico
Albuquerque, New Mexico
Albuquerque is the largest city in the state of New Mexico, United States. It is the county seat of Bernalillo County and is situated in the central part of the state, straddling the Rio Grande. The city population was 545,852 as of the 2010 Census and ranks as the 32nd-largest city in the U.S. As...
. The company also has offices in Bloomington, MN, Chicago, IL, Jacksonville, Florida
Jacksonville, Florida
Jacksonville is the largest city in the U.S. state of Florida in terms of both population and land area, and the largest city by area in the contiguous United States. It is the county seat of Duval County, with which the city government consolidated in 1968...
, Hoover, Alabama
Hoover, Alabama
Hoover is a city in Jefferson and Shelby Counties in north central Alabama, in the United States. The largest suburb of Birmingham, the population of the city was 62,742 as of the 2000 census and 81,619 in the 2010 census. Hoover is part of the Birmingham-Hoover, AL MSA and is also included in the...
, Pittsburgh, PA and Washington, D.C.
Washington, D.C.
Washington, D.C., formally the District of Columbia and commonly referred to as Washington, "the District", or simply D.C., is the capital of the United States. On July 16, 1790, the United States Congress approved the creation of a permanent national capital as permitted by the U.S. Constitution....
Prime Therapeutics is the largest privately held PBM in the United States that does not own any chain pharmacy stores and whose stakeholders are Health Care Service Corporation
Health Care Service Corporation
Health Care Service Corporation , with 13 million members in its Blue Cross and Blue Shield Plans in Illinois, New Mexico, Oklahoma and Texas, is the nation’s largest non-investor-owned health insurer and fourth largest overall....
, Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabama
Blue Cross and Blue Shield of Alabama is a health insurance company headquartered in Birmingham, Alabama. The company, which was founded in 1936, provides coverage to more than 3 million people and is a member of the Blue Cross and Blue Shield Association....
, Blue Cross and Blue Shield of Minnesota, Blue Cross and Blue Shield of Nebraska, Blue Cross and Blue Shield of Kansas, Blue Cross Blue Shield of North Dakota, Blue Cross and Blue Shield of Florida, Blue Cross Blue Shield of Wyoming and Blue Cross and Blue Shield of Montana. Its major competition comes from companies such as Caremark Rx
Caremark Rx
Caremark Pharmacy Services is the prescription benefit management subsidiary of CVS Caremark Corporation, headquartered in Woonsocket, Rhode Island and Nashville, Tennessee.-Company history:...
, Medco Health Solutions
Medco Health Solutions
Medco Health Solutions, Inc is a health care company currently serving the needs of more than 65 million people. Medco provides pharmacy services for private and public employers, health plans, labor unions, government agencies, and individuals served by Medicare Part D Prescription Drug Plans...
, Express Scripts Incorporated
Express Scripts Incorporated
Express Scripts, Inc. is a Fortune 100 company headquartered in Cool Valley, Missouri. It began in 1986 in St. Louis, Missouri as a result of a joint venture between a retail chain of more than 79 pharmacies and Sanus Corp. Health Systems. Express Scripts was purchased by New York Life Insurance...
, and Catalyst Rx. Prime Therapeutics covers nearly 19 million lives across 18 different Blue Cross and Blue Shield Plans, 184,000 employer groups.
Prime is also one of the regional processors for Medicare Part D for the Blue Cross Blue Shield plans that own it: HISC (a subsidiary for Health Care Service Corporation
Health Care Service Corporation
Health Care Service Corporation , with 13 million members in its Blue Cross and Blue Shield Plans in Illinois, New Mexico, Oklahoma and Texas, is the nation’s largest non-investor-owned health insurer and fourth largest overall....
), the Northern Plains Alliance (BCBS of Minnesota, North Dakota, Noridian a BCBSND company, Nebraska, Wellmark, Wyoming and Montana) and Blue Cross Blue Shield of Florida. With BCBS Minnesota it also includes South Country Health Alliance, PrimeWest Health System, the state sponsored health plan called Pre-Paid Health and First Plan of Minnesota.
Prime also provides specialty pharmacy management to its Blue Cross and Blue Shield clients through its Triessent program. The Triessent program provides safe and efficient medication delivery, personalized member support, and a comprehensive set of tools for managing specialty drug spend under both the pharmacy and medical benefit.
History
- 1987 - Pharmacy Gold is established as the pharmacy department for Blue Cross and Blue Shield of Minnesota, offering a therapeutically complete drug formulary to other plans across the country.
- 1993 - Pharmacy Gold is incorporated in July and begins independent financial operations in September.
- 1998 - Pharmacy Gold, Inc. merges with ProPar - a third party administrator and service bureau, and is renamed Prime Therapeutics, Inc. Prime is a privately held corporation and is owned by five BCBS affiliates including Blue Cross and Blue Shield of Minnesota, Blue Cross and Blue Shield of Nebraska, Blue Cross and Blue Shield of North Dakota, Blue Cross and Blue Shield of Kansas and Blue Cross and Blue Shield of Wyoming.
- 2003 - Health Care Service Corporation (HCSC) - which comprises Blue Cross and Blue Shield of Illinois, Blue Cross and Blue Shield of New Mexico and Blue Cross and Blue Shield of Texas - purchases equity ownership
- 2004 - Prime Therapeutics, LLC is formed. Blue Cross and Blue Shield of Oklahoma purchases equity ownership in Prime.
- 2005 - PrimeMail®, Prime's mail service pharmacy, is launched and begins dispensing prescriptions. Blue Cross and Blue Shield of Oklahoma is purchased by HCSC and releases its direct ownership of Prime.
- 2006 - Blue Cross and Blue Shield of Florida joins Prime as both client and owner, becoming the tenth BCBS plan to invest in Prime. Prime opens its second PrimeMail facility.
- 2007 - Prime achieves URACUracURAC, formerly known as the Utilization Review Accreditation Commission, is a nonprofit organization promoting healthcare quality by accrediting healthcare organizations.- Mission :...
Pharmacy Benefit Management accreditation. Prime is named semi-finalist in the International Customer Management Institutes's (ICMI) Global Call Center of the Year awards. - 2008 - Prime accepts its first mail-service only client. Prime launches Triessent®, its specialty pharmacy program. Prime joins the Pharmaceutical Care Management AssociationPharmaceutical care management associationThe Pharmaceutical Care Management Association , is the American national trade association representing pharmacy benefit managers. According to the association's mission statement, PCMA advocates on behalf of its member companies, which claim to improve affordability of prescription drugs and...
, the national association representing America's pharmacy benefit managers. - 2009 - Blue Cross and Blue Shield of Montana becomes the eleventh BCBS owner of Prime. PrimeMail begins accepting electronic prescriptionsElectronic prescribingElectronic prescribing or e-prescribing is the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of...
via the Surescripts network. - 2010 - Prime again receives URACUracURAC, formerly known as the Utilization Review Accreditation Commission, is a nonprofit organization promoting healthcare quality by accrediting healthcare organizations.- Mission :...
accreditation for its mail service pharmacy, PrimeMail. Blue Cross and Blue Shield of Alabama becomes the twelfth BCBS owner of Prime.
Source: Prime Therapeutics
Electronic Prescribing
PrimeMail mail service pharmacies are fully enabled for electronic prescribingElectronic prescribing
Electronic prescribing or e-prescribing is the ability to send error-free, accurate, and understandable prescriptions electronically from the healthcare provider to the pharmacy. E-prescribing is meant to reduce the risks associated with traditional prescription script writing. It is also one of...
and support the following messaging protocols via the latest NCPDP SCRIPT
SCRIPT (medicine)
SCRIPT is a standard promulgated by the National Council for Prescription Drug Programs for the electronically transmitted medical prescriptions in the United States.-Adoption:The first version of SCRIPT was approved in 1997...
standard on the Surescripts network:
Electronic Prescriptions (NEWRX)
Electronic Refill Requests (REFREQ/REFRES)
Medication History Requests (RXHREQ/RXHRES)
Prime Therapeutics as a PBM also supports the ANSI X12 270/271 protocol for formulary and eligibility requests for all of its clients.