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10 days to contract: digital mental healthcare via the PBM, faster than ever

Lauren Lazo 08.14.2020

Benefits leaders are the unsung heroes of corporate America — ensuring that thousands of employees can access their benefits quickly and seamlessly. As we look to 2021, providing mental health support is the leading priority for employers, according to EHIR.

But as the mental health crisis worsens, budgets tighten, and new solutions continue to pop up, the task of evaluating digital solutions for mental health is more overwhelming than ever. Fortunately, there’s a faster (and easier) way to cut through the noise: working with your pharmacy benefit manager (PBM).

Evaluated to be safe, secure, & effective

You can now offer digital solutions for mental health and other chronic conditions through your PBM — enabling you to support your employees in need, faster and easier than ever. 

By opting for coverage on the PBM formulary, evaluating, contracting, and billing can be managed as easily as drugs. Each digital solution offered through this channel undergoes a rigorous evaluation process ensuring that they have proven clinical outcomes, adhere to strict privacy and security regulations, and will help drive down healthcare costs. Meaning you have 1, 2... or 10 less hoops to jump through and can offer mental health support to your employees sooner. 

Streamlined contracting and implementation

Gone are the days of redlining 50+ pages of MSA’s and SOW’s — you need only update your existing agreement to elect and offer select digital solutions through your PBM service.

Implementation and enrollment for digital mental health solutions is also much easier, taking advantage of pre-existing PBM systems (i.e. no need to collect and send eligibility files). Plus, you can target and reach employees with the highest need.

Reimbursement, reimagined

Instead of dipping into a tightening wellness budget, you can pay for digital mental health solutions via your existing PBM invoice, drawing from the medical or pharmacy budget if you choose. Claims are processed just like a drug on the formulary, and you’re only billed when an employee signs up to use the product. 

In this time of heightened need, it has never been more important to provide access to evidence-based care quickly and easily. All of the above allowed one client to offer proven digital solutions for mental health in just ten days:

“With the growing number of solutions in the market, securing the necessary budget and the contracting process can both be burdensome. With only a one-page amendment and streamlined billing through the pharmacy budget, we were able to get the approvals we needed to launch in just 10 days - it was a simple process.”
— Lynne Haney, benefits manager at AmeriGas

A track record that speaks for itself

In June 2019, Sleepio became the first digital solution to be offered and billable via a pharmacy benefit manager (PBM). With the addition of Daylight one year later, we’ve expanded this industry-first way to provide and pay for evidence-based digital solutions to our entire 24-hour mental health solution (Sleepio for poor sleep, and Daylight for worry and anxiety). 

We believe that the future of employee mental healthcare is one that creates less friction for benefits teams. With the way this changes contracting, coverage, and reimbursement, we hope you’ll join us in our mission to help millions back to good mental health — faster and easier than ever.

Read more about our partnership with a leading pharmacy benefits manager (PBM) in our recent press release.


Disclaimer: Sleepio and Daylight are not intended for diagnosis or treatment of a disease or condition, such as Insomnia Disorder, Generalized Anxiety Disorder or Major Depression Disorder.

Users are directed to not make any changes to their prescribed medication or other type of medical treatment without seeking professional medical advice.