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ARMSRx News
ARMSRx Tackles the New Rx Addiction -- Pharmacy Benefit Audits
ORLAND, Fla.,
Auditing is a critical, yet often overlooked piece of the prescription benefits package. The pharmacy benefit itself is complex and presents a host of opportunities in which errors can occur. Fraud, hierarchical benefit rules and simple human error can place the payor at significant financial risk. Payors must regularly review the processing of pharmacy claims to ensure accurate adjudication is taking place. Case in point: in one of our recent reviews performed for an ARMSRx client, it resulted in some compelling findings — specifically, over $100K in incorrectly adjudicated claims that affected over 4% of claims processed. "Fortunately we are able to find these measurable discrepancies and identify solutions moving forward" states Jennifer Kingsley-Wilson, CEO of ARMSRx.
ARMSRx is an advocate for the payors and understands the complexity of the Rx benefit and the problems that ambiguously worded contracts and pricing structures can create. ARMSRx ensures their clients are recipients of what is rightly available to them with regards to the various pieces that make up the pharmacy benefits program.
ARMSRx has the experience interpreting and applying PBM contracts from the PBM vendors in today's marketplace. Even payers satisfied with their current level of PBM service can benefit from a thorough review to ensure that in-force contracts are being correctly applied and performance guarantees are set at an appropriate level to make the payer whole in the event of costly errors.
ARMSRx is privately owned and is proud to be independent and objective. Our proprietary system, ARMSRx E-Audit, is customized to meet each client's needs. Please visit our website at www.ARMSRx.com or call 800.578.9714 for more information.
Contact: Jennifer Kingsley-Wilson CEO of ARMSRx 800.578.9714
SOURCE ARMSRx
