How is EXL Pharmacy Benefit Management different.
EXL combines healthcare domain expertise, analytics capabilities, and digital assets to help PBM clients transform
We have helped PBM clients improve pharmacy claims review processes to uncover discrepancies, save millions of dollars on a monthly basis, and improve network communication and compliance
Our collaborative approach helps PBMs contain costs, enable capacity growth, and address quality care gaps
We empower PBM leadership with insights enabling them to maximize operational efficiencies, improve medication adherence, and ensure appropriate medication utilization
What we do

EXL’s predictive analytics solutions, clinical quality and utilization management services, workflow technology, and prescription claim auditing capabilities help PBMs improve pharmacy benefit management. We enhance pharmacy operations, enable digital transformation, and provide powerful population health insights that let PBMs achieve market growth and expansion.

Pharmacy Utilization
Management
Creates efficiencies and accuracies across operations
  • Ensure cost containment
  • Improve quality outcomes
  • Focus resources where needed most

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Pharmacy Quality and Care Management
Better patient experiences and outcomes
  • Unlock insights by leveraging HEDIS, STARS, and P4P performance
  • Maximize returns
  • Improve patient care

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Payment Integrity for Prescription Claims
Controlling costs and maximizing revenue
  • Reduce costs associated with incorrectly billed or overpaid pharmacy claims
  • Focus on prevention, avoidance, and recovery

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Real Results

Digital Intelligence is the foundation of everything we do and inspires our ideas and research.

WHY EXL

Achieving growth in the PBM space requires overcoming complex challenges. EXL enables PBMs to reach their goals and contain costs, improve revenue, and enhance patient experiences and outcomes.

Using advanced analytics, powerful data assets, deep domain expertise, and next-generation digital solutions, EXL helps PBMs with pharmacy utilization management, quality and care management, payment integrity for prescription claims, and other important areas. By orchestrating our full suite of solutions, our clients can unlock value and gain a competitive edge.

3 OF THE top 5 PBMs
partner with us
LEADER
Everest Group: Clinical Care Management Services and Healthcare Analytics PEAK MatrixTM Assessments (2019)
2,400+
Global Clinicians
TOP RANKING
“Payer Quality and Risk Analytics” KLAS (2018)
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