Pharmacy services
We work with you to optimize outcomes and improve operational effectiveness
Health plans and PBMs can improve pharmacy management with our predictive and prescriptive analytics solutions, clinical quality and utilization management services, workflow technology, and prescription claim auditing capabilities.
We enhance pharmacy operations, enable digital transformation, and turn raw data into a strategic asset, providing powerful population health insights that let you stay competitive and achieve market growth and expansion.
Who we serve
We work with health plan and PBM clients in managing their pharmacy programs to empower pharmacy managers to focus on what matters most — improving member outcomes and quality, containing costs, and ensuring members and providers receive the best experience possible.
Solution sheet
EXL Digital Audit Solutions
Solution sheet
EXL Digital Audit Solutions
<p>It starts with the stacks of binders you now store on premise, containing the documents the DEA requires you to hold for two years. Our team scans these forms and uploads the digitized PDFs, along with associated metadata, into the cloud for easy search and access.</p>
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Solution sheet
<p>It starts with the stacks of binders you now store on premise, containing the documents the DEA requires you to hold for two years. Our team scans these forms and uploads the digitized PDFs, along with associated metadata, into the cloud for easy search and access.</p>
Infographic
PBM and Pharmacy client reporting
Infographic
PBM and Pharmacy client reporting
Legacy PBM and pharmacy client reporting systems often lack structure, capability, and efficiency. Reports are dense, hard to navigate, and provide minimal value to the client. It’s not uncommon for reports to be dozens pages, with the information difficult to digest and lacking clarity on client recommendations.
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Infographic
Legacy PBM and pharmacy client reporting systems often lack structure, capability, and efficiency. Reports are dense, hard to navigate, and provide minimal value to the client. It’s not uncommon for reports to be dozens pages, with the information difficult to digest and lacking clarity on client recommendations.
Solution sheet
Minimize payment disputes, increase collections and prot...
Solution sheet
Minimize payment disputes, increase collections and protect revenues
<p>Pharmacy Benefits Managers (PBMs) are losing millions in drug manufacturer rebates due, in part, to growth of the 340B discount drug-pricing program and a severe lack of a solid data management structure. As a result, manufacturers have begun to scrutinize everything, causing sharp decreases in reimbursements, alongside sharp increases in payer/client audits, paperwork and reporting.</p>
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Solution sheet
<p>Pharmacy Benefits Managers (PBMs) are losing millions in drug manufacturer rebates due, in part, to growth of the 340B discount drug-pricing program and a severe lack of a solid data management structure. As a result, manufacturers have begun to scrutinize everything, causing sharp decreases in reimbursements, alongside sharp increases in payer/client audits, paperwork and reporting.</p>
Case study
Innovation during pandemic results in successful virtual...
Case study
Innovation during pandemic results in successful virtual pharmacy audit program
Pharmacies play a critical role in keeping communities healthy. When the COVID-19 pandemic hit, pharmacies needed to take special measures to protect their customers and staff, including limits on who was allowed onsite. These adaptations impacted pharmacy audits, which are essential to cost containment, overpayment identification, and compliance.
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Case study
Pharmacies play a critical role in keeping communities healthy. When the COVID-19 pandemic hit, pharmacies needed to take special measures to protect their customers and staff, including limits on who was allowed onsite. These adaptations impacted pharmacy audits, which are essential to cost containment, overpayment identification, and compliance.
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