February 4, 2021

Zooming in on Transparency in Pharmacy Benefits

On This Episode:

Does the number 835 mean anything to you? It should. You need to make sure there’s language in your audit rights with your PBM contract that allows access to the 835 file. Those files contain payment information and shows how much money pharmacies are reimbursed by PBMs. The difference between what you paid for the drug, and what the pharmacy was reimbursed is kept by the PBM. Does that sound like your PBM is working for you? Let’s find out.

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Scott Long

Authored By

Scott Long, CPBS, CHVP

Executive Advisor

 

Meet Scott