Real-time Compliance

A ClaimCheck audit is conducted on a bi-weekly basis for each invoice you receive from your PBM. It eliminates the need for an annual, retrospective audit and allows corrective action for identified problems before they amount to a large dollar amount.

This product is essentially a real-time contract and plan design compliance audit performed on each claim load and matched to your PBM invoice. It was  introduced to the market in 2007 and has since resulted in a overall client savings of 1.5%. The replaces the annual “pay-and-chase” audit with a real time communication module to both payor and vendor.

“It’s reassuring to know that someone is looking at our claims on a daily basis to ensure compliance standards.”