Rebate Audits

Solutions

Manufacturer rebate dollars represent a substantial portion of the underlying financial equation impacting prescription costs these days. Plan sponsors need to validate this complex component as they require greater transparency in their PBM relationship.

Caribou Systems has the expertise and technology to assist payers in evaluating rebate receivables including validation of minimum per claim rebate guarantees, client share of pass through rebates, and PBM’s annual reconciliation of final rebate payments. Our detailed reconciliation process ensures that our clients receive all eligible rebates based on plan utilization, clinical program restrictions, and contracted pass through share of rebates and administrative fees, as applicable.

CARIBOU REBATE AUDITS ADVANTAGES

  • Caribou is an approved rebate audit vendor for all the major PBMs.
  • We maintain a clear focus on the audit and provide an objective vantage point.
  • Our analysts are experts at performing the complex calculations in rebate audits and evaluating the impact of your clinical program on rebate dollars.
  • Our familiarity with the contract language associated with rebate manufacturers means we know what to expect and watch out for.
  • Our extensive experience with the unique data sets each PBM elects to provide in support of rebate audits ensures our analysts are able to focus on the outliers instead of just getting the job done.

 

For more information about how we can help your organization,
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