Pharmacy Claim Audits (Management)

Prescription drug prices are a key element of double-digit increases in health care benefit costs.

Our qualified team of pharmacy technicians and medical directors offer clients complete pharmacy consulting services, which consist of:

  • A thorough review and analysis of the current pharmacy benefit plan design.  ACCURATE pharmacists will assess the current plan and identify the key drivers of cost increases for pharmaceuticals. In addition, we will recommend programs that deliver the right mix of cost and utilization management.
  • An analysis of pharmacy claims. Our pharmacist consultants will review all pharmacy claims data and analyze cost structures to determine the actual payment configuration of current pharmacy claims and utilization patterns of medications. This information will be used to assess if the current pharmacy plan design is being followed or if there are hidden spreads, network price manipulations, rebate games and/or other fees escalating medication costs for clients. The information will also be used to assist in creating an optimal pharmacy benefit design plan.
  • A detailed report of findings and plan design recommendations. ACCURATE will prepare and submit a final report based on the plan design of our clients’ business and wellness objectives.