Insights from TFG Partners
Pharmacy Claim Auditing Matters Now More Than Ever Higher prescription costs and the need to reduce them are driving shake-ups in the PBM landscape. Today, we see an increasing number of health plans changing or questioning their pharmacy benefit managers (PBMs). In every case, there is a vital role to play in a thorough Request […]
The value of medical claim auditing for self-funded health plans is affirmed in many ways each year – it always pays to review what’s happening with your third-party processor. The latest example to make TPA oversight a topic in the news is a class-action lawsuit filed against UnitedHealthcare Group (“UHCG”) over out-of-network payments. The giant […]
It’s never been a better time to audit your Pharmacy Benefit Manager (PBM) and the claim payments it makes on your plan’s behalf. With drug price increases expected in 2023 for commercial and employer-sponsored health plans, keeping an eye on things will be vital.
If you’re a medical benefit plan manager and hearing about Rx co-pay optimizers, this article is for you. The question our clients have is, how much can an optimizer save my plan?
When large and medium-size employers weigh the value of medical claims auditing and continuous claims monitoring service, we remind our clients there are added values to consider.