Goold Health Systems Continues to Make Its Mark on Medicaid Nationwide

GHS Deploys electronic Pharmacy Point-of-Sale, Prior Authorization, Drug Rebate, & related pharmacy systems for the State of Utah to improve patient care and help control costs

Goold Health Systems Continues to Make Its Mark on Medicaid Nationwide

Goold Health Systems (GHS), a nationally recognized health care management company focusing on Medicaid services, recently implemented new electronic Pharmacy Claims Point-of-Sale (POS), Prior Authorization (PA), and Drug Rebate systems for the State of Utah Department of Health, Division of Medicaid and Health Financing (DMHF). This further strengthens GHS’ growing national influence in the health care arena.

In doing so, GHS replaced Utah Medicaid’s in-house legacy system that processes about 4 million Medicaid claims per year, making Utah’s new POS (NCPDP vD.0 compliant), PA, and Rebate systems a win for the state, providers, and Medicaid patients. A real-time POS system allows pharmacies to submit claims electronically to verify recipient eligibility, identify covered drugs, determine prior authorization criteria, price claims, monitor Medicaid drug policies, and screen recipient medical and prescription history within the Medicaid system – all within seconds.

GHS established Utah’s new, comprehensive pharmacy system to:

“We are pleased to work with states across the nation because we bring innovation while also concentrating on clinical efficacy and cost-containment,” said GHS CEO Jim Clair. “The State of Utah was an excellent partner as we stood up our pharmacy systems for its Medicaid program, and it continues to be a terrific partner as we mutually work toward enhancing care and saving money at the same time.”

Utah’s new pharmacy system is provided as Software as a Service, meaning Utah employees are now operating the pharmacy tools. GHS hosts the applications and provides ongoing updates to the system to keep system functionality and technology current. The project period is five years with two one-year renewal options.

Founded in 1974 and affiliated with the Waldron Group of Companies, GHS has built a national presence, providing pharmacy and other services to 15 State Medicaid Agencies. GHS is headquartered in Augusta, Maine, with offices in Cheyenne, Wyoming, Des Moines, Iowa, and Atlanta, Georgia. For more information, please visit .

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