PBIRx Service Overview

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

For over a decade, the team here at PBIRx has been assisting clients with the management of their pharmacy benefit plans to ensure that they are receiving desired healthcare outcomes at the lowest possible cost. Since pharmacy costs can represent 16% to 40% of of all healthcare costs today depending on demographics, and since the costs of drugs and services are ever changing, entities that provide pharmacy benefits must remain in tune with the changes to ensure that the pricing in their PBM contract is accurate and up to date; this is exactly where we come in!

When matched with our own proprietary algorithms and similar cutting edge technology, the expertise and knowledge of our diverse staff allows us to create cost saving solutions for our clients with regards to their pharmacy benefit plans. Although you may assume that your plan will be carried out following the terms within, the truth of the matter is that there are instances where either your PBM is not adjudicating claims according to your contract terms or you are not receiving the rebates and discounts that are more competitive from the start. The following is just a brief overview of the services we proudly offer to assist you in these areas:

• Pharmacy Benefit Consulting
• Pharmacy Benefit Auditing (Using Audit Rx)
• Pharmacy Benefit Actuarial Services
• Third Party 340B Compliance Audits
• First Fill Optimization
• Clinical Algorithms To Detect FWA and Gaps Of Care
• Rebate Aggregation

Within each of these services, we will carefully analyze your current plan and see where your PBM has drifted from the agreements stated in your contract. Should adjustments need to be made, we will recommend modifications and new plan designs using the most up to date information about pricing as it relates to the healthcare services you currently receive. And the best part is, you will not have to sacrifice any of your desired healthcare outcomes to receive certain rebates and discounts; we will find you the savings you deserve all while maintaining the pharmaceutical drugs and services you are entitled to through your plan.

Have you yet to have your plan analyzed for potential discrepancies in terms of cost? If so, don't wait, connect with an expert like PBIRx today. To learn more about our services, please visit us on our website or give us a call at (888) 797-2479.