Is your Pharmacy Benefit Manager [PBM] acting in your best interests - or their own?
PBMs often hide their major sources of profit:
PBM Contracts - unless properly negotiated - are generally one-sided.
Benefits are often designed to maximize PBM profits at the expense of health plans and recipients.
PBM Audits
Our PBM audits are almost always ‘productive’- recovering important dollars for our clients.
Audit & Evaluation Services
Fixed fee evaluation & overview
Claim by claim audits to validate:
— Pricing accuracy
— Eligibility of recipients
— Adherence to benefit design
— Full and timely rebate payments
— correct days supply dispensed
— And more.