Posts in prescription drug clai...
12,500+ Prescriptions Impacted by PBM Mistake
12,500+ Prescriptions Impacted by PBM Mistake

This nationally recognized electronics and technology company engaged BMI to conduct a pharmaceutical audit of their prescription drug plan and pharmacy benefit manager (“PBM”) to ensure claims were being processed correctly.

Read More
Audit Finding of the M..., AUDiT iQ, audit samples, BMI Audit Services, claim audit, claims audit, claims data, claims administrator, cost-containment solution, health care benefits a..., health care claims, health plan audit, internal audit department, pbm, payment errors, pharmacy benefits manager, prescription drug clai..., retrospective auditRobert Temples
Pharmaceutical Audit Reveals over $500,000 in Errors
Pharmaceutical Audit Reveals over $500,000 in Errors

This major metropolitan hospital engaged BMI to conduct a pharmaceutical audits of their prescription drug plan and pharmacy benefit manager (“PBM”) to ensure claims were being processed correctly.

Read More
Audit Finding of the M..., AUDiT iQ, audit samples, BMI Audit Services, claim audit, claims audit, cost-containment solution, drug exclusion, ERISA, health care benefits a..., health care claims, health plan audit, pbm, payment errors, pharmacy benefits manager, prescription drug clai..., prior authorization, retrospective audit, Self-Insurance Programs, systemic flawRobert Temples
Recurring Pharmaceutical Audit Continues to Prove Beneficial
Recurring Pharmaceutical Audit Continues to Prove Beneficial

For over 10 years, this large public school district has engaged BMI to conduct annual pharmaceutical audits of their prescription drug plans and pharmacy benefit manager (“PBM”).

Read More
Audit Finding of the M..., AUDiT iQ, audit samples, BMI Audit Services, claim audit, claims audit, claims data, cost-containment solution, health care benefits a..., health plan audit, health care claims, pbm, pharmacy benefits manager, payment errors, prescription drug clai..., prior authorization, re-enrollment auditRobert Temples
Annual Pharmaceutical Audit Uncovers Systemic Errors
Annual Pharmaceutical Audit Uncovers Systemic Errors

This large county government engages BMI to conduct annual pharmaceutical claims audits of their self-insured pharmaceutical plan and pharmacy benefit manager (PBM). In addition, the client also engaged BMI to conduct a contractual financial guarantee audit.

Read More
Audit Finding of the M..., pharmacy benefits manager, pbm, prescription drug clai..., payment errors, health care claims, health care benefits a..., financial guarantee audit, BMI Audit Services, audit samples, AUDiT iQRobert Temples
Medical & Rx Audit Yields Big Savings for Employer Group
Medical & Rx Audit Yields Big Savings for Employer Group

At the recommendation of their consultant following concerns about the accuracy of claims adjudication, this employer group approached BMI to conduct an audit of medical and prescription drug claims paid by their third-party administrator. 

Read More
Audit Finding of the M..., AUDiT iQ, audit samples, BMI Audit Services, claim audit, claims administrator, claims audit, claims data, cost-containment solution, health care benefits a..., health care claims, health plan audit, medical and prescripti..., Medical Claims Audits, payment errors, prescription drug clai..., retrospective audit, Self-Insurance Programs, Third-Party Administrator, TPA audit, Value ForwardRob Temples
Savings Follow Audit of Client’s Third-Party Administrator
Savings Follow Audit of Client’s Third-Party Administrator

BMI was engaged to audit this manufacturer’s new third-party administrator for both their medical and prescription drug plans to ensure benefits were being paid appropriately and to evaluate overall administrative effectiveness.

Read More
Audit Finding of the M..., AUDiT iQ, audit samples, BMI Audit Services, claim audit, claims administrator, claims audit, claims data, cost-containment solution, duplicate payments, health care benefits a..., health care claims, health plan audit, medical and prescripti..., Medical Claims Audits, payment errors, prescription drug clai..., prior authorization, Third-Party Administrator, TPA audit, Value ForwardRob Temples
Claims Audits – An Immediate and Future Cost Reduction Strategy
Audit Finding of the M..., AUDiT iQ, audit samples, BMI Audit Services, claim audit, claims administrator, claims audit, claims data, cost-containment solution, drug exclusion, duplicate payments, eligibility, eligible dependent, health care benefits a..., health care claims, health plan audit, medical and prescripti..., Medical Claims Audits, payment errors, pbm, pharmacy benefits manager, plan eligibility, prescription drug clai..., retrospective audit, Third-Party Administrator, TPA audit, Value ForwardRob Temples