The AUDITRACK© System utilizes paid prescription data to define areas of concern. Using pre-determined criteria, the AUDITRACK© System identifies Pharmacies to be audited as well as the specific prescriptions to be audited. The sentinel affect resulting from in-store audits and desk reviews is an effective tool to increase compliance and reduce fraud and abuse.

   The AUDITRACK© System utilizes paid prescription data to perform a series of Reviews ranging from the Physician who wrote the prescription, to the Pharmacy who filled the prescription to the PBM who processed the prescription, to the Patient who used the prescription. The paid prescription data yields a wealth of information when processed through the AUDITRACK© System. Areas of fraud, waste, and abuse are identified in addition to PBM and Pharmacy errors. The claims data is also essential for Rebate Reviews and prospective Rebate Consulting.

   For Prescription Programs that do not have in-house Pharmacy personnel, Pharm/DUR© will assign a Staff Pharmacist to work with the Program’s Prescription Claims personnel. A Pharm/DUR© representative will use his/her expertise to provide assistance in PBM Contracting, Plan Design and Pharmacy Related Issues.

   The AUDITRACK© System’s Physician, Patient, Pharmacy and Drug Profiling gives you a snap shot of the prescribing habits of your Physician Panel, your Members’ Drug Utilization, and the claims billed by your Pharmacy Network. Reports on Drug Usage by Therapeutic Class help you to identify your drug costs. Patient Profiling results in Drug Use Reviews when problems are identified. These profiles provide evidencery material when it is necessary to remove a provider or member from the Network Panel.