Commercial Payers

By combining hard data with human intelligence, HealthPlan Data Solutions (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, and ensure compliance.

Our Technology Platform Reviews 100% of Claims Prior to Payment

Identify

HDS proprietary analytics technology identifies errors and utilization trends using 100+ scans in five key domains, including contractual terms, plan design, and more.

Fix

HDS pharmacy benefit experts help you and your PBM collaborate to determine the root causes of errors, reclaim payments, and prevent future overpayments.

Monitor

HDS analysis provides ongoing, near real-time reviews of 100% of pharmacy claims to ensure optimal contract performance and compliance.

With HDS, commercial payers can realize savings of 3–8% beyond the contractual guarantee.

Ensuring PBM Payment Integrity for the Nation’s Largest Commercial Payers

HDS is a software solutions 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

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 payment integrity for every claim.

Blue Cross Blue Shield Plans

Blue 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.

“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.”

Mark Pettitt, President & CEO of Preferred Benefits Services Inc.

Learn How HDS Can Maximize the Value of Your PBM Relationship