“We were able to realize 10:1 ROI on the targeted audits and reviews that PSG performed on our behalf.”
Current Health Plan Client
Audits
SOLUTIONS
Audits
Our PBM auditing expertise offers extensive pharmacy program monitoring, assurance of accurate program implementation, and a comprehensive analysis of PBM contract adherence. Full-scope and a la carte audit options are available to give you the flexibility to choose the appropriate bundle of audit services that meet your unique needs.
Audit recoveries last five years
Audits over last 3 years
Average audits with recoveries
Audit Types
| Audit Type | Commercial | Medicare | Medicaid |
|---|---|---|---|
| Benefit Validation Audit | ✓ | ✓ | ✓ |
| Electronic Audit of Minimum Rebate Guarantees | ✓ | ✓ | ✓ |
| Eligibility Audit | ✓ | ✓ | ✓ |
| Financial/Pricing Audit | ✓ | ✓ | ✓ |
| Fraud, Waste & Abuse Audit | ✓ | ✓ | ✓ |
| Network Transparency Validation Audit | ✓ | ✓ | ✓ |
| Operational Compliance | ✓ | ||
| Onsite Rebate Audit | ✓ | ✓ | ✓ |
| Performance Guarantee Audit | ✓ | ✓ | ✓ |
| PDE Audit | ✓ | ||
| Pre-/Post-Implementation Audits | ✓ | ✓ | |
| Prior Authorization Audit | ✓ | ✓ | ✓ |
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