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Pharmacy Consulting
PRAM is one of the nation's leading Pharmacy Consulting firms. Our pharmacy staff has many years of experience in managing and controlling rising pharmacy costs.
PRAM Provides Pharmacy Benefit Expertise to Potential Clients
Our pharmacy staff will review your benefit programs to ensure they meet the potential requirements of your Company. Included in the review would involve your pharmacy processor Contractual Arrangements, Utilization and Financial Data, Benefit Design, Implementation Processes and Clinical Programs. We will listen and act on your issues.
Initial Review
With your authorization, PRAM will obtain detailed claims data and use our proprietary systems to verify the contracted pricing, copays, edits, fees, and overall benefit design features are in place. We will also review the service aspects of your pharmacy plan.
On-Going Consultation
PRAM will present regular Pharmacy Data Reports for your review. With the use of our proprietary Predictive Modeling Tools, we will accurately forecast your pharmacy expense for the upcoming months or year. With your options of change to your benefit design, we can use the models to show the financial effect the changes will have.
PBM Selection
PRAM has created a unique study of the leading PBMs and can correctly place your program with the best suited PBM. We can help with the negotiation and selection of the PBM to ensure your Company has the best possible financial and service partner.
PBM Audit
For the audit, we wil obtain and analyze two years of PBM claims data. This audit would be in depth to verify the PBM adjudication processes of eligibility, contracted pricing and plan design structure. We would then produce a report package to show the accuracy and also any discrepancies. Our program traces each claim adjudication back to an individual prescription number and dispensing date. There is no extrapolation of claims made with our program, each claim is examined for compliance. Results are presented in a set of reports identifying and calculating overcharges that have occured. These reports are used to negotiate settlements with the PBM.
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