By combining hard data with human intelligence, HDS translates complex pharmacy benefit data into insight, enabling you to maximize the value of your PBM services, identify mid-contract opportunities for cost savings/avoidance, and ensure compliance. The HDS Spotlight platform offers services which are additive to existing commercial PBM oversight and monitoring.
Pharmacy Analytics that Continuously Review 100% of Paid Claims to Ensure Accuracy
HDS proprietary pharmacy analytics technology identifies claim-level errors and using 250+ scans in five key domains, including contractual terms, plan design, and more.
Through our SaaS, Hybrid, or fully outsourced model, impacted claims are continuously identified and error resolution is expedited with the PBM.
Once a fix has been implemented, the HDS platform continues to monitor the change over time to ensure its durability for the life of the contract.
Looking to Add Continuous Monitoring to Your Claim Adjudication Process?
Ensuring Payment Integrity for the Nation's Largest Commercial Payers
HDS is a software company that offers a holistic, post-adjudication, prepayment solution that cuts through contractual complexities and brings visibility and accuracy to your pharmacy spend data.
Commercial plans continue to see pharmacy costs increase 5–7% per year. HDS solutions and expertise help arrest those costs by ensuring full transparency and appropriate payment for every claim.
Blue Cross Blue Shield Plans
Blues plans feel obligated to contract with a PBM owned by a competitor. HDS brings greater visibility to these transactional agreements to reduce spending and more efficiently manage plans.
HDS Pharmacy Analytics Solutions for Commercial Payers
HDS provides additive solutions that can be customized to suit the unique needs of your pharmacy team.
In the first year, Rx costs for the group were reduced by 22%. They experienced another 5% reduction in the second year with flat utilization. I would recommend HDS because of their unflagging determination in bettering the understanding and culture of their clients, while also helping them realize year-to-year cost savings.
The Kentucky General Assembly has made it a priority to increase oversight of our Commonwealth’s pharmacy benefit managers. Over this past year, HDS has successfully delivered on our vision by enabling greater transparency and establishing pharmacy payment integrity between KEHP and their contracted PBM. Their efforts have been beneficial for our taxpayers, KEHP, and represent a model for other states to consider implementing.
[HDS] is a strong communicator on difficult topics. We appreciate the laconic approach. It was clear their team is very experienced in the pharmacy benefit space and were essential in helping our team navigate the error resolution process efficiently.