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.
Interested in Adding Continuous Claims Monitoring?
Add the Power Of Advanced Pharmacy Analytics to Your Commercial Offering
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.
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.