
RxAmerica's commitment to our customers doesn't stop once you select us. Our auditing department performs many valuable functions, focusing on pharmacy compliance and plan design, to provide our customers with the value added services for which RxAmerica is known. These services include:
Plan Design Audits
- Our team of benefit auditors verifies that the plan design is implemented correctly before the benefit goes live. Any changes to the benefit are audited to insure accuracy and avoid unnecessary member disruption.
Pharmacy Audits
- These fall into two categories, onsite audits and desktop audits.
Onsite Audits - RxAmerica examines pharmacy practices and procedures and generates a report card, either by aggregate pharmacies or by individual pharmacy. We then share the report card with our customers to keep them aware of the overall performance of the pharmacies operating within their plan's specified network.
Desktop Audits - Our pharmacy professionals perform a complete, monthly analysis of pharmacy prescription claims. Our audit team uses this analysis to identify claims that fall outside of plan-established parameters. After reviewing each selected claim, RxAmerica contacts the pharmacy to verify the accuracy of those prescriptions. If errors in over-billing have occurred, RxAmerica contacts the pharmacy to recoup the money for the customer.
Report Audit
- All reports are audited for complete accuracy before they are sent to a customer.