Pharmacy Advisory, Auditing and Risk Management Services

Because of the complexity of pharmacy benefit contracts and the inherent cost inefficiencies of the pharmacy benefit management system, RBS developed a comprehensive risk management program to identify, eliminate, and manage to the highest possible level of cost efficiency.  On-going due diligence and pro-active vendor management are key to the success of our program and include monthly audits and bi-weekly clinical reviews by our clinical pharmacist.

The savings of this approach cannot be achieved with the traditional methods of retrospective audits and reviews.  All aspects of risk management are included in our comprehensive approach to pharmacy benefit risk management:


· Strategic planning

· PBM RFP marketing

· PBM contract review & negotiations

· Vendor implementation management

· Claims auditing & vendor oversight

· Daily clinical oversight

· Plan design modeling and recommendations

· Risk assessment and program development

· Market pricing checks

· PBM Contract re-negotiation

The bottom line for clients is our ability to maximize the cost efficiency of their benefit dollars without sacrificing member benefits or service levels.