Government payers
We combine advanced technology with deep pharmacy expertise to analyze adjudicated prescription claims, track utilization trends, identify billing errors, and recover costs for government payers — including Medicare, Medicaid, FEHB, and state-run employee health plans.
Real transparency. Meaningful accountability.
We help government payers improve transparency, protect taxpayer funds, and support better outcomes. PBMs process large volumes of complex claims, making real-time oversight challenging. We work with you to identify, fix, and monitor pharmacy payment errors — helping you meet CMS expectations, reduce waste, and strengthen program integrity.
Transparency that supports Medicaid performance
We partner with fee-for-service and managed Medicaid plans to ensure every claim is billed accurately. That means fewer missed savings, better use of taxpayer dollars, and improved care for the members who need it most.
Oversight that strengthens MA contracts
Strict requirements and rising costs demand real visibility. We provide MA plans with claim-level insight and contract-specific logic to help them meet CMS standards and maximize plan performance.
Expert guidance that considers FEHB complexity
FEHB plans face unique challenges, from layered contracting to rising cost pressure. Our team brings deep federal experience and purpose-built tools to simplify oversight and protect program integrity.
Support for state-run programs
State-run benefit programs often mirror the complexity of commercial plans while carrying the public accountability of government oversight. We provide the tools and expertise states need to deliver smarter care, control pharmacy costs, and ensure better value for employees.
