Third Party Administrators
Executing on pharmacy claim accuracy is essential to providing high quality claim adjudication service and value for your clients. HDS not only enables TPAs to stand by their guarantees, but provides an objective way to validate them.
Leverage a Technology Platform to Monitor 100% of Claims as They Adjudicate
HDS proprietary pharmacy analytics technology identifies claim-level errors using 250+ scans in five key domains, including contractual terms, plan design, and more.
Once claim errors are identified, TPAs can quickly perform a root cause analysis and expedite a fix.
Once a fix has been implemented, the HDS Spotlight platform serves as an ongoing quality check to ensure the fix remains in place.
Looking to Add Continuous Monitoring to Your Claim Adjudication Process?
Add the Power Of Advanced Pharmacy Analytics to Your Claims Processing
Add a Key Differentiator
It is important that TPAs provide competitive bids with regard to Admin Fees. When augmented with HDS Spotlight, our TPA clients go above and beyond to offer guaranteed financial accuracy which can be the difference between winning and losing and RFP.
While most TPAs offer some level of financial accuracy, many come up short when it comes to validating the proposals they signed. With HDS Spotlight, TPAs gain the ability to provide claim-by-claim analytics to show how much their clients are really saving. When payers demand for a high degree of accuracy, our TPA clients can deliver.
HDS Pharmacy Analytics Solutions for Third Party Administrators
HDS provides additive solutions that can be customized to suit the unique needs of your client base.