Compliance Audits

A basic review of claims and their adherence to your PBM contract pricing and plan design.

The Compliance Audit is TRICAST’s primary level pharmacy claims audit that verifies PBM contract and benefit plan design claims processing compliance. This is a first step in the process of eliminating waste in your pharmacy benefit program. The fiduciary requirements are satisfied for pharmacy benefit program management oversight.

In addition, the Compliance Audit allows benefits managers to re-establish a relationship of trust with their PBM and communicate this to corporate stakeholders, plan members, and plan management.