Which of the following is NOT a service provided by PBMs?

Study for the Certified Pharmacy Benefit Specialist Exam. Explore flashcards and multiple-choice questions, each accompanied by hints and explanations. Be fully prepared for your test!

Pharmacy Benefit Managers (PBMs) play a crucial role in managing prescription drug benefits for health plans and their members. Their services include a range of functions designed to improve the efficiency, cost-effectiveness, and quality of pharmacy care.

Utilization Management involves overseeing the appropriate use of medications to ensure that patients receive the necessary treatments while also managing costs. This encompasses prior authorization, step therapy, and drug utilization reviews to prevent inappropriate medication use and maximize therapeutic outcomes.

Claims Adjudication is another core function, where PBMs process prescription claims from pharmacies, determining coverage and payment based on the member's drug benefit plan. This ensures that claims are settled quickly and accurately, making the process seamless for both pharmacies and patients.

Disease Management is a service designed to help patients with chronic health conditions by providing education, support, and resources to manage their diseases effectively. PBMs often have programs aimed at specific diseases that guide patients through their treatment options and help ensure adherence to medications.

Pharmacy Compliance Monitoring, while important in the overall healthcare ecosystem, is not a standard service offered directly by PBMs. Instead, it is more often associated with regulatory bodies or other healthcare entities that ensure healthcare practices comply with laws and guidelines. Therefore, this option is identified as the

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