OpioidCM

Client Onboarding Guide

Implementation & Reporting Overview. A smooth, predictable process designed to minimize internal burden and deliver measurable outcomes.

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Program Overview

OpioidRx is an evidence-based opioid prevention program that identifies early prescribing risk patterns using de-identified pharmacy claims. Our objective is simple: ensure a smooth implementation with minimal internal burden while delivering measurable clinical and financial outcomes.

Phase 1
Baseline Risk Analysis

Phase 2
Prescriber Engagement

Phase 3
Monitoring & Reporting

  • No system integration is required.
  • No disruption to your existing health plan.
  • No patient health information (PHI) is collected.

Implementation Timeline

Implementation is structured, predictable, and designed to minimize your team's administrative effort.

Weeks 1 - 2

Data Intake and Validation

Weeks 3 - 4

Baseline Analysis & Executive Reporting

Month 2

Provider Engagement Begins

Month 3

First Progress Update Delivered

Ongoing

Quarterly Monitoring & Structured Reporting

Data Requirements & Privacy

OpioidRx analyzes paid pharmacy claims using blinded member identifiers. Secure encrypted file transfer is provided, and our technical team works directly with your designated data contact.

What We Need

  • De-identified member ID
  • National Drug Code (NDC)
  • Fill dates & Quantity
  • Days supply
  • Prescriber identifier
  • Paid amount

What We DON'T Need

  • No Names
  • No Social Security Numbers
  • No Addresses
  • No Personal Health Info (PHI)

Compliance Assurances

All data is de-identified. No prescription access restrictions are imposed, and physicians retain full clinical autonomy. This program supports better-informed clinical decisions without interfering with appropriate patient care.

Provider Engagement

Licensed clinical pharmacists conduct structured outreach to providers identified through our prescribing profile analysis. Your organization is not required to participate in these conversations; OpioidRx manages the entire engagement process.

The Outreach Process Is:

Educational Evidence-based CDC-aligned Non-accusatory Documentation-focused

The objective is to support appropriate tapering or transition decisions when clinically indicated. Historically, 95-99% of contacted providers adopt recommended documentation improvements.

Reporting & Success Metrics

We believe prevention produces both clinical and financial outcomes. Savings occur because the underlying clinical uncertainty is addressed upstream.

Baseline Risk Report (Day 30)

  • Number of members exposed to opioid risk
  • Prescribing pattern distribution & provider profiles
  • Estimated cost impact & reduction opportunity

Ongoing Quarterly Reports

You will receive quarterly performance reports structured for executive leadership and board-level review, measuring:

  • Reductions in high-risk opioid prescriptions
  • Improvements in prescriber documentation standards
  • Decreases in opioid-related healthcare encounters
  • Stabilization of related medical costs

Roles, Responsibilities & Support

Your Organization

  • Provide claims data via secure transfer
  • Designate a primary contact
  • Review quarterly reports

OpioidRx

  • Data analysis & prescriber identification
  • Pharmacist outreach & engagement
  • Monitoring and documentation
  • Executive reporting

Need Implementation Support?

We are committed to structured communication and measurable results.

Schedule a Consultation