OTC Benefit Solutions, provided by Fieldtex, is a mail-order Over the Counter Benefit Catalog Program designed to supplement Medicare Advantage Health Plans. In the competitive Healthcare market, a Supplemental OTC Benefit is a major selling point for Health Plans. Not only do we provide the Benefit, but we also provide continuous reporting so that the Health Plan can monitor activity and make beneficial changes for future member use.

Through our plan design, only eligible members are able to place orders for items that are pre-approved and are only able to spend up to their pre-determined benefit allowance.  We also have the ability to allow only one shipment per month per member if desired by the plan to keep freight cost down.  We provide monthly utilization reports based on product, plan and State. Offering real-time access to robust plan reports allows Health Plans to conduct more objective assessments and predict plan forecasting.

Plan Utilization Reports Include:

  • Overall Usage
  • Usage by plan – if applicable
  • Product Utilization
  • Call Metrics
  • Beneficiary Expenditures
  • Monthly Sales
  • Freight Analysis

We also provide monthly call reports that allow us to monitor the service level that is expected for the Medicare Members.

Call Reports Include:

  • Call Volumes
  • Response Times
  • Service Levels

We even offer custom reporting for aspects such as popular products, electronic billing, etc. We work with the Health Plan to determine and provide relevant and up to date reporting that can be used to shape the Benefit Program to best meet the needs of the member population. Whether it’s adjusting the product list, the benefit amount, or the benefit frequency, the insight provided by these utilization reports can guide the Health Plan in making constructive changes to the Benefit Program with the goal of increasing member satisfaction, and ultimately retaining and increasing member enrollment.

The Importance of Utilization Reporting in an Over-the-Counter Benefit Program