HDS PBM Insight™

HealthPlan Data Solutions (HDS) is a software solutions company that leverages leading-edge, data-mining technology to analyze, validate, and compare PBM performance across key industry benchmarks, empowering our clients to ensure 100% of their claims are correctly adjudicated, invoiced, and paid.

HDS PBM Performance and Compliance Tools™

Gain insight into how a PBM’s services compare to industry standards and validate market competitiveness and adherence to regulatory, contractual, and plan design requirements.

HDS BenchMarket Pricing™

Gain access to market-competitive unit prices for pharmaceuticals with HDS BenchMarket, a proprietary, survey-based pricing analysis tool. By using a wide variety of market pricing data, acquisition costs, and market experience, HDS BenchMarket calculates an industry standard that can be used to validate the accuracy of PBM pricing and MAC pricing values.

HDS RFP Scoring™

Access our RFP Scoring expertise and proprietary technology to score a PBM RFP in a way that gives you clear insight into choosing the right PBM with the best contract terms at the right price. HDS RFP Scoring evaluates contract terms, plan design, formulary pricing, and rebate terms to determine which PBM provider has the lowest net cost.

HDS PBM Certification™

Use HDS PBM Certification to evaluate PBM performance mid-contract or as a quality assurance tool that validates 100% of your adjudicated claims for accuracy. Our certification program gives you certainty in real-time that contract terms are being met or exceeded by analyzing and measuring PBM performance against a variety of key benchmarks for the PBM industry. Certification enables both payers and PBMs to formally validate the accuracy of PBM performance.

HDS Annual PBM Audits™

Ease the administrative burden of your PBM Audit by working directly with the industry leader in auditing PBM performance. Our HDS Annual PBM Audit program delivers on financial returns while also quickly identifying and addressing contractual and process issues that may limit your ability to manage your pharmacy benefit effectively.

HDS Rebate Audits™

Find out just how much you may be missing from your rebate program. HDS Rebate Audits allow you to quickly and accurately gain 100% certainty that PBM rebate payments align with rebate agreements and standard drug classification criteria.

PBM Oversight that Benefits Everyone

100% Claims Accuracy

The HDS technology platform helps assure that every benefit claim is administered and paid appropriately according to the contract and plan design, giving both payers and PBMs more peace of mind.

Optimized Performance

Leverage ongoing measurement and score-carding of PBM performance across key industry benchmarks, and gain certainty that contract terms are validated—even in complex contractual environments. Having these insights can reveal opportunities to improve performance.

Improved Collaboration

Real-time monitoring and analysis of pharmacy claims identify payment discrepancies and empowers payers and PBMs to work together to fix errors, avoid overpayments, and ensure compliance.

Maximize the Value of Your PBM Services.