Payment Integrity White Paper
HDS Pharmacy Payment Integrity White Paper
“Learn how access to claims data and AI technology solutions can help return leverage back to the plan sponsor…”
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THE WHITEPAPER FOR HOW TO REBALANCE THE SCALE
What You’ll Learn…
The Main Issues Putting Payers at Odds with PBMs
The history of PBMs in the pharmacy space has evolved significantly over the years. We take a deep dive on how we got to where we are today. From industry consolidation to misaligned incentives, plan sponsors are at a disadvantage.
Why The Traditional PBM Playbook Falls Short
Traditional methods for mitigating overspending and PBM oversight often include market checks, PBM RFPs, and retrospective audits. While these solutions offer savings, they are retrospective and don’t address the root causes of error.Â
The Impact of Real-Time Rx Claim Monitoring
Implementing a continuous monitoring solution to check every claim finds errors as they occur. This whitepaper highlights some of the key areas to look, as well as real-world case studies of what’s been realized as a result.
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