Your Forensic Lab in a Suit Coat
PBM FINANCIAL
AUTOPSY (audit)
This is where the DNA evidence lives – and is often buried. We trace every penny from PBM to Plan.
Our Offer:
Elite Level PBM Financial Auditing
We don’t summarize; we dissect. We challenge the rebate math, assess guarantees against your actual mix, surface definition games and channel leakage, then calculate and help to collect what’s owed — then we amend the contract so the fix sticks.
We also run stand-alone Benefit, MAC, and Discount reconciliations when you need precision strikes.
Competitors Deliver Book Reports
WE DELIVER A CORNOER'S REPORT
...and wire the remediation into governance.
If a competitor tells you our approach is “too aggressive,” ask them why enforceable terms make them nervous.
How We Overdeliver
- Rebate revenue lineage mapping, cross-matching formulary placement, definitions, and class-of-trade shifts.
- Discount and guarantee validation with year-end true-up and interest where applicable.
- Benefit code audits — prior-auth logic, step-therapy rules, accumulators, day-supply, DAW impacts.
- MAC and specialty spread analysis; ingredient cost vs dispensing fee integrity checks.
- Corrective action plan that becomes contract addenda — not a PDF that gathers dust.
Word for the wise…
If your pharmacy consultant’s last “audit” ended with “monitor going forward,” they audited your patience — not the math.
Ready to save on healthcare?
Let’s optimize your pharmacy benefits and drive down costs. Our team of experts is here to guide you through every step of the process. From regulatory compliance to patient savings, we’ve got you covered. Don’t leave money on the table—reach out today and discover the difference.