PBM Audits & Reviews
A comprehensive PBM audit is an important tool to truly understand how your prescription drug plan is doing today and how to best manage it for the future. Lowering pharmacy costs requires extensive knowledge to decipher the ambiguity and complexity in pharmacy contracts, PBM systems, formularies, claims and plan design.
Through a comprehensive PBM audit, plans can become informed and active consumers, understanding drug benefit design, evaluating the efficiency of drug utilization, monitoring the performance of their PBM and assessing if the costs charged and services provided were in accordance to the terms of the contract.
When Was Your Last Audit?
PBM contracts that have not been reviewed in the last 12 months are typically not up to date and not achieving market improvements. Audits can save money by identifying incorrect pricing, claims processing errors, as well as inaccurate plan design and clinical program set-up.
ARMSRx performs the following types of audits:
- PBM Contract Review
- Financial Guarantees
- Administrative Fees
- Pharmacy Claim Payments
- Performance Guarantees
- Rebate Guarantees
- Implementation Audit
- Formulary and Clinical
- Benefit Plan Design
- And more
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“Strong support and immediate response…”
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