Medicare Part D Audit Services

Retiree plan sponsors have all the standard concerns regarding administration of pharmacy benefits along with the additional level of complexity associated with navigating through Medicare Part D subsidies. The foundation of oversight begins with Caribou’s standard suite of Pharmacy Claims Audit Services, where we can ensure that your PBM has implemented your benefits correctly, is accurately administering your contract terms, and has accounted appropriately for manufacturer rebates.

Caribou’s expertise can also help you maximize government subsidies while ensuring CMS compliance, whether you participate in the Retiree Drug Subsidy (RDS) program or have an Employer Group Waiver Plan (EGWP). Our background in eligibility, benefits and claims processing systems, combined with our proprietary pharmacy claims audit tool, CRx, provides the robust and flexible solution required for the complexities inherent in Medicare Part D processing.

Our pharmacy auditing system, CRx, enables our team of Pharmacy Claim Auditors to navigate the complexities inherent in Medicare Part D processing.

We have been helping our clients receive the maximum subsidies while ensuring compliance since the inception of the Medicare Part D program.

For more information about how we can help your organization,