Pharmacy Consulting

As the workforce has aged and drug costs of risen, pharmaceutical costs have increased exponentially. A pharmacy benefit strategy that looks at your budget as well as the needs of your employees is a key component for keeping your benefit plan costs in check. Prescription drug pricing varies, depending on the drug and the pharmacy. Bridge Insurance Group has partnered with Pharmacy Outcomes Specialists to provide our clients with expert pharmacy benefits consulting, designed to help lower costs, alleviate confusion and frustration, and increase the health and productivity of your employees. The BIG team has the expertise and tools to compare pricing and helps your employees comparison shop for their prescriptions.

For Plan Sponsors

For Plan Sponsors – Corporations, Unions and Mid-Sized HMOs
• Requests for Proposals (RFPs) for PBM services
• Contract Review and Analysis
• Renewal Analysis
• Carving Out Pharmacy from the Medical Plan
• Audits of Financial Terms
• Audits of Plan Design
• Audit of Rebate Payments
• Ongoing Monitoring of Financial and Service Performance

Plan Sponsors Contracting with Retail Pharmacies or Plans Needing Fraud, Waste and Abuse (FWA) Programs
• Report analysis of retail network and mail order aberrant behavior
• Desk audits to cost effectively determine and investigate errors
• On-site audits to investigate fraud, waste or abuse
• Investigations of provider, member and/or pharmacy collusion
• Waste by pharmacies in not dispensing low cost generic products
• Dashboard analytics of potential fraud, waste or abuse for plan sponsors

Services for Medicare Part D Plan Sponsors
• Fraud, Waste and Abuse Programs
• Reporting to CMS
• Auditing of Pharmacies, Physicians, Members and PBMs
• Audit Medicare Part D Programs
• PDE reconciliation
• Medicare Part D Plan Design (TrOOP, LICS)


Benefits Solutions


Automating Tasks


Negotiating the Best