Helios: A Merger Between Progressive Medical and PMSI

 

In 2014 Progressive Medical and PMSI announced that the two companies, which merged in October 2013, would be known as Helios starting in August 2014. The company will deliver comprehensive pharmacy benefit management services including end-to-end pharmacy, ancillary, and settlement solutions to the workers.
Initially, this was their website.
Content is from the site's 2014 -2015 archived pages.

In 2016 OptumRx Inc., (www.optum.com) the pharmacy benefit management unit of UnitedHealth Group Inc., acquired workers compensation PBM Helios. A spokesman for Minnetonka, Minnesota-based OptumRX said that Helios will be folded into Optum's existing workers comp and auto no-fault PBM business.

 

 

Relevant: It was quite a journey companies who had hired Helios for their comprehensive pharmacy benefit management services went through until OptumRX finally acquired them. I should know since until recently the company and us employees went through the shift from one owner to another. Fortunately OptumRX came through and their solutions of supporting employee wellness and guiding them to the right care and resources was great. Recently I was offered a new job in New York City. I jumped at the chance. Initially I was concerned about what type of managed health care the new job would offer. Hearing that they too used OptumRX was a relief. I had been working for an online marketing agency assigned to promote MoonAtMidnight.com, an exceptional online retailer offering Batman shirts, sweatshirts, and hoodies. Their products are amazing, especially the newer sublimated prints that had glorious colors, detail and a crisp print job that jumped off the shirt. For the first time, I even purchased some shirts form myself and my brother's kids as gifts. As a lifelong Batman fan I was really liking this job, but as the contract was coming due, Batman would no longer be on my horizon, and a job in the Big Apple was my dream. Hello NYC, we are ready.

 

CIRCA 2015

HELIOS, the new name of Progressive Medical and PMSI, is bringing the focus of workers’ compensation and auto-no fault pharmacy benefit management, ancillary services, and settlement solutions back to where it belongs – the injured party. Along with a new name comes a passion, focus, and intensity on delivering value beyond just the transactional savings for which we excel. 

WE LEAD BY EXAMPLE: WITH INTEGRITY, RESPECT, AND HUMILITY

With more than 150 years of relevant industry experience, our leadership team is highly visible, actively engaged, and dedicated to guiding you to the best possible outcome. Whether we’ve been your partner for years, or if you’re just learning how our innovative products and services improve outcomes for you and the injured people you serve, our team is committed to doing what’s right.

 

Are You Right for Helios?

Helios is experiencing unprecedented growth as a company and we are offering fantastic opportunities for both entry-level AND experienced professionals. We are always looking for people who enjoy challenging work, thrive on exceeding expectations, and delight in providing exceptional service. We offer positions in the following areas:

Customer Service

Customer service associates and representatives in both pharmacy and ancillary services delight in helping our customers make better decisions to assure a clear path to recovery. Positions include:

• Customer Service Associates and Representatives
• Team Leader
• Supervisor
• Manager

Clinical Services

Evidence-based medicine, as well as national and regional medical guidelines not only lead the development of our programs but the decisions we make. We hire pharmacists and nurses to provide sound clinical guidance to our clients to make certain injured persons receive the right medications, products, and services at the right time. In addition to proficiency in medication therapy and multidisciplinary care, we seek clinicians with comprehensive understanding of work-related injuries and pain management. Positions include:

• Clinical Pharmacist
• Clinical Pharmacist Liaison
• Nurse Case Manager

Information  Technology

We stay on the forefront of technology, providing our clients and employees with the latest tools to make their jobs a little easier. IT/IS professionals at Helios work with a variety of computer languages and systems, including Java, Perl, IBM, Windows, and Linux. Positions include:

• Programmers
• Developers
• Network Engineers
• System Engineers/Analysts/Administrators
• Programmer Analysts/Administrators
• Database Administrators
• Telecom/Voice Engineers

Corporate Positions

Successful delivery of high quality products and services requires a variety of skill sets, experience, and talent. We are always on the lookout for passionate individuals eager to make a positive difference and help our business grow. Professional positions are available in a variety of service areas, including Account Management, Sales, Human Resources, Finance, and Marketing.

Wondering if Helios has a position that will make you shine? Check out our available job opportunities in Florida, Ohio, Tennessee, and Utah.

 

 

Introduction/Acceptance of Terms

Welcome to Helios' website. Helios offers you a wide variety of products and services, including general content, communication tools and online and downloadable applications on the following terms. By using this service, in any way, you are agreeing to comply with these terms, which we may update without notice and encourage you to check out at any time. You must be at least 18 years old and competent to enter into a contract to use the service. The use of this site and the terms and conditions for the sale of any goods and services is governed by the Terms of Service Agreement and the disclaimers and caveats in this site. You accept and will be bound by the terms thereof.

Security

You are responsible for all activities that occur under your password or account and will keep your password confidential. You will immediately notify us of any unauthorized use of your password or account or any other breach of security. You will not disrupt the functioning of the service, solicit another user's password, or otherwise act in a way that interfaces with other users' use of the service. You may not post or distribute any computer program that damages, detrimentally interferes with, surreptitiously intercepts or expropriates any system, data or personal information.

Services or Goods

Each form and document provided through this site should be treated as a starting point and should not substitute for professional legal analysis. The service is provided and each form and document is licensed with the understanding and agreement that owner, any content provider and any author, are not engaged in rendering legal, accounting or other professional services. 

Limitation of Liability

Under no circumstances shall Helios, its subsidiaries or its licensors be liable for any direct, indirect, punitive, incidental, special or consequential damages that result from the use of or inability to use, this site. This limitation applies whether the alleged liability is based on contract, tort, negligence, strict liability or any other basis, even if Helios has been advised of the possibility of such damage.

 

 

About Helios

At Helios, doing what's right matters. Our products and services enable better decisions and achieve better outcomes. They get injured people the right medications, products, services, and settlements at the right time. They reduce program costs by looking beyond transactions, by avoiding payments for medications and services that should not be paid, and by pairing robust analytics with veteran clinical expertise. This leads to brighter insights and greater savings.

The Story behind Helios

Sparked by the merger of Progressive Medical and PMSI, Helios has provided solutions for workers’ compensation and auto no-fault cost containment for nearly 40 years. Our proven, integrated solutions include:

  • Pharmacy Benefit Management (PBM)
  • Ancillary Services
  • Settlement Solutions

The systemic combination of these three programs creates a synergy of information that results in more control, better outcomes, stronger compliance, a healthier patient, and a healthy bottom line.

 

 

Workers’ Compensation

At the heart of Workers’ Compensation is one inescapable fact: someone has been injured, he or she would like to not only get well, but to also get back to work - as safely and quickly as possible. That's why at Helios, doing the right thing is so important. For the injured worker, it means less hassle, fewer worries, and the safest, most appropriate and effective clinical care. For you, it means a healthier bottom line, less paperwork, and informed decision-making. In short, a better outcome for everyone.

Our solutions for Pharmacy Benefit Management (PBM), Ancillary Services, and Settlement Solutions, were created specifically to give you the insight to do what’s right. For example:

  • There’s always someone accessible to help you and the injured worker
  • Ancillary services are thoroughly evaluated for quality and reliability
  • Claims are tracked from the very first fill, lighting the way toward positive outcomes
  • Pace-setting analytical tools and clinical expertise to advance the injured worker's recovery, while protecting you from unnecessary costs

Whether you are an insurance carrier, third party administrator, governmental entity, or self-insured employer, we are lighting the way forward through enhanced services, accessibility, clinical insights, and industry-leading predictive analytics. This means more than managing pharmacy transaction costs, processing prescriptions, or answering the phone. It means each and every Helios associate working with accountability and determination. It means doing the right thing, for everyone.

Influences

There are many factors that can influence workers’ compensation and auto no-fault claims. These can have a tremendous impact on both an injured person’s recovery and the costs associated with the claim. We believe it is important to understand those influences, share our findings with you, and work toward positive change in the industry. Following are overviews of the top influences in the industry with additional resources for more information.

 

Pharmacy Benefit Management at Helios

Helios Pharmacy Benefit Management (PBM) is committed to doing what's right. This commitment has sparked innovations that decrease costs while increasing safety. Our services:

  • Make filling a prescription easier, with up to 98% retail network penetration
  • Reduce your administrative burden by capturing more prescriptions in-network
  • Mitigate potential high-risk, high-cost situations
  • Are backed by 24/7/365 service and accessible, hands-on leadership
  • Ensure safe and effective medication therapy for the injured worker

Our carefully crafted program is easily managed by a fully redundant and secure claims management platform. In addition, we provide injury-specific Medication Plans and formularies, as well as client-specific business rules. Ongoing communication keeps everything flowing.

 

 

Auto No-Fault Solutions from Helios

Fueled by Helios, AutoMed Solutions™ provides pharmacy benefit management and ancillary services that control the growth of medical costs while doing the right thing for the injured person. It’s the natural result of insightful and innovative features, such as the nation’s largest, most complete retail network, advanced analytical tools, and pace-setting clinical expertise.

All of this enables you to make better decisions throughout the life of the claim, beginning with the first fill. This provides the ability to: 

• Track and manage available no-fault benefits
• Capture prescriptions and services "in-network"
• Achieve better outcomes with timely clinical insights
• Enable hassle-free transactions with no out-of-pocket patient expenses
• Provide vetted, quality ancillary services
• Begin lighting the way forward to settlement

For policyholders, this means fewer hassles, lower costs, and a better overall claim experience. For you, it means fewer administrative headaches, an improved bottom line, and satisfied policyholders. This is what happens when you do what's right; and why Helios is unlike any No-Fault benefits program you’ve ever experienced before. 

 

Helios Patient Rights and Responsibilities Rights/Appeals

  • You have a right to having your personal information kept private and secure in accordance with federal and state law and regulation. Please see Helios’ Privacy Policies for additional information.
  • You have a right to receive services without regard to race, creed, national origin, sex, age, disability diagnosis or religious affiliation.
  • You have a right to access your medical records.
  • You have a right to receive timely information and explanations about coverage decisions.
  • You have a right to appeal coverage decisions with your payer and/or health plan.

Responsibilities

  • Provide accurate and complete account and medical information.
  • Report any change in your condition.
  • Follow medical advice and work collaboratively with providers and your insurer/payor to carry out the agreed-upon treatment plan.
  • Be knowledgeable about your drug therapy.
  • Report any suspected wrongdoing or fraud to Helios.

Complaints/Issues/Service Comments

We appreciate all types of feedback. You may detail compliments, questions or issues to Helios by visiting the “Contact Us” section of the Web site or via U.S. mail, phone or fax using the information below. An associate will provide you with a response.

Helios
250 Progressive Way
Westerville, OH 43082
Phone: 800.777.3574
Fax: 614.923.7650

 

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