TRICAST Over the Counter

We understand that there’s more to pharmacy benefits risk management than raw data. You need information, too. Here you’ll find ideas, insights, analysis, and solutions from the thought leaders at TRICAST.

Over the Counter: Autumn 2016

Click  below to download the latest OTC!   Save Save Save Collaborate. Share. Succeed. Ever wonder if there’s a better way? A way to work with leaders who understand your daily challenges? Leaders who know how to increase positive engagement and safeguard against...

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Why Prescription Benefit Plan Sponsors Should Audit

Many sponsors of prescription drug benefit programs have operated on blind faith for too long. They have depended on their pharmacy benefit manager (PBM) to deliver safe and effective prescription drug coverage to their plan members while helping to reduce costs. The...

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Schemes and Scams

TRICAST recently participated in a conference call and presentation held by the Centers for Medicare & Medicaid Services. The seminar focused on fraud schemes and the latest data that they are making available to help entities identify and investigate potentially...

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Dealing with Rejected Claims Analysis

A CMS Best Practice for Identifying Medicare Part D Formulary and Transition Issues If you work in a Medicare Prescription Drug (Part D) plan most likely you have felt some anxiety over the thought of a CMS (Centers for Medicare and Medicaid Services) compliance...

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Dealing with Rejected Claims Analysis

A CMS Best Practice for Identifying Medicare Part D Formulary and Transition Issues If you work in a Medicare Prescription Drug (Part D) plan most likely you have felt some anxiety over the thought of a CMS (Centers for Medicare and Medicaid Services) compliance...

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Providers, Pharma and PBMs: Three Things to Watch

Providers and Pharma and PBMs—I refer to them as the “Three Ps” and they make up what I suppose you could call the Trinity of pharmaceutical benefit delivery in this country—have been much in the news as of late. And it’s not a stretch to say that the news hasn’t...

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Needles, Haystacks and the Myth of Statistical Sampling

I’m asked all the time: “You don’t really need to readjudicate 100% of our claims data, do you? Wouldn’t doing a statistical sample be accurate enough?” Not to put too fine a point on it, but no. It’s not accurate enough. And in fact it’s not really accurate at all....

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Stop Fighting for Today

Stop fighting for today – You have already lost. Healthcare, any part of it, is a very competitive business. You know that. You also know that it isn’t getting any less competitive despite the major mergers. Every dollar, every inch and every customer matters....

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