Adjudication

Make us your Managed Pharmacy Program Partner

Pre-adjudication allows opportunity for our team to provide real time management of an Rx prior to dispense and shipping to the facility. Pre-adjudication is always backed up by post-adjudication (sometimes known as Audit). This process allows us to identify when the managed pharmacy program rules have not been implemented. The program is real time constant management of your pharmacy costs including census payer management. All our adjudication is software driven. 

However, each patient is unique and has multiple nuances that may not be picked up on a typical software driven adjudication. Every single one of our clients receive double adjudication both software driven and manually reviewed for the biggest return and most effective analysis. We are so confident we can reduce your pharmacy spend we guarantee it. 

You do not pay us unless you receive 150% return on your investment in the pharmacy savings program. One low flat rate provides you with analytics, pharmacy negotiation, constant monitoring, non-covered medication assistance and authorizations, and managed care carve out billing support. 

Our rebate program provides a guaranteed return, formulary management, and utilization control programs.

 

With Medicare and Medicaid, things can change tomorrow. That’s why we stay on top of the latest releases from the CMS and Congress.

Ready to get started?

Our team is standing by to help assess your needs and identify the best services to reduce your pharmacy spend.