The Benefits Of Auditing Your Pharmacy Benefit Plan

PBIRx®

Intelligent Solutions in Pharmacy Benefits

612 Wheelers Farms Road, Milford, CT 06461

(888) 797-2479

Although you may have a fantastic relationship with your PBM and trust that they are billing the pharmacy claims according to the terms and agreements outlined in your contract, you are only doing yourself an injustice by not having a professional with state of art technology and experts to examine your claims file as compared to contract language and discounts to confirm accuracy of adjudication. After all, it is very easy for things to get lost in translation or during the time that your PBM's personnel manually enters data. 

When you have your pharmacy benefit plan audited by an expert like PBIRx, you can be sure that the financial terms, rebates and guarantees in a PBM contract are met by your Pharmacy Benefit Manager and that any discrepancies are negotiated in your favor.  

As a providing entity, an auditing program such as our own, Audit Rx, will give you control over the terms stated in your contract so that you know exactly what discounts and rebates you should be receiving. And the best part? If you have lost out on savings because your PBM has not acted according to the terms in your contract, when you audit with PBIRx, you can earn those savings right back! We have a proven track record of negotiating extensive recoveries for our clients due to discrepancies in what is stated in a contract vs. the actions taken by the PBM. Through both our Audit Rx program and our 340B compliance audits, you can rest assured that you're not paying a penny more than necessary.

With the new year well underway, are you finally ready to have your plan audited for accuracy? If so, we're ready to help! To learn more about our pharmacy benefit auditing services, visit us on our website or contact us at (888) 797-2479 today!