PHARMACY BENEFITS MANAGEMENT – Pharmacy Bill Review

We help healthcare organizations drive cost reduction and revenue enhancement through improved efficiency and effectiveness and process transformation.

  • Best-in-class series (Claims, Enrollment, Medical Management)
  • Requirements
  • Product evaluation and selection
  • Operational readiness (BPS)

Our offerings

  • Standard Bill Review
  • Complex Bill Review
  • Complex Bill Negotiations
  • Bill Review Expert Witness

Our pharmacy bill review services enable you

  • Be compliant with fee schedule and payer’s rules
  • High cost savings
  • Accurate and fast reviews with detailed EOB
  • Overall reduction in medical cost

Our competencies

  • In-house clinical, billing and coding expertise
  • In-house expertise to conduct complex and specialty bill review
  • Expertise in integrating state laws, case laws, coding technicality
  • Advanced data analytics
  • Ability to deliver data driven results