Audit Services
Prudent Rx offers a wide variety of audit programs in the pharmacy and PBM arena. These include Facility Site Reviews, Pharmacy Audits, PBM Audits and Formulary / Rebate Audits. We also offer unique programs for MCO's and IPA groups with contracts that may be at full or partial risk for the pharmacy dollar.
The auditing of pharmacy providers and pharmacy
claims is a critical service component of any managed care program.
It is often the only way to deal with the pharmacy fraud, billing errors
and patient/physician abuse concerns and questions posed by Medical Directors, COO's, CEO's and CFO's, "Are the claims valid? Do they meet program parameters? How do we know that members received their medications? What happens to prescriptions not picked up by members?" A successful audit program must be able to address desk audits as well as in-store audits.
Prudent Rx has developed a sophisticated
relational database application and ad-hoc reporting system, Inspect Rx,
which allows us to generate specialized audit reports using complex
algorithms to identify potential problem prescriptions, pharmacies,
physicians, and providers; the four "P's" of the Prudent Rx audit program.
The information discussed here is a high level overview of the products and services we offer. If you would like to receive additional information on our programs, please complete the request form, or contact Prudent Rx at any of the following:
Prudent Rx, Inc.
100
Corporate Pointe, Suite 395
Culver City, CA 90230
310.642.1700
310.642.1701 fax
sales@prudentrx.com
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