Services

Audit Services

If you are not auditing your current PBM agreement,
you are leaving money on the table.

AlignRx has developed a comprehensive collection of audit products to meet your clients’ needs. Pharmacy benefit manager contracts are complex and very difficult to understand. PBMs intentionally leave contracts vague with confusing terminology to limit their liability from underperformance. As a result, very few employers or TPAs actually audit their pharmacy benefit manager contracts. That is a huge mistake. We estimate that over 60% of clients are owed money by their PBMs.

The AlignRx financial audit process has recovered millions of dollars for our clients.
Our automated process reviews 100% of all claim transactions for these vital elements:

We’re taking audit to the next level. Through our proprietary audit application, we give you real-time audit capabilities. You get real-time monitoring of your utilization rate against your contract terms. So you no longer have to wait six months after the year to determine contract compliance.

Discounts

Dispensing Fees

Offset Language

Admin Fees

Exclusions

Adjudication Logic

Rebates

True-up Payments

Would you like to talk about better outcomes?

AlignRx is ready to help.

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