PBM Audits are powerful tools in better understanding this significant source of plan costs, and in our experience most result in both money due back to the plan sponsor and recommended changes for future cost reduction. Many audits offered in the pharmacy market are really just pricing analyses conducted for the purpose of trying to secure the brokerage account for the employer. While these assessments offer value, we built our PBM audit platform to truly test the accuracy of claims payments with the same comprehensive Audit Process as our medical plan audits.

What makes dental audits by JGI particularly effective is our experience with industry standards and detailed benefits testing. Rarely do dental audits uncover significant dollar amounts of errors, but they often find multiple benefits that are either not properly set up or are applied manually with high error rates. The fact that we do not use any dollar value cutoffs in our approach and our willingness to test every benefit possible result in successful, comprehensive dental audits conducted with the same approach and care as medical audits.

We take the time to understand client priorities and develop a communication strategy and customized materials that fit each client’s culture. Clients find that our approach to this portion of the project is much more customized and hands-on than the industry norm, though our pricing remains competitive and our performance guarantees exceed expectations.