Contingency Fee-Based, Rx Audit and ERISA Plan Asset Recovery Service

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Presentation transcript:

Contingency Fee-Based, Rx Audit and ERISA Plan Asset Recovery Service HR Specialty Products & Services Catalogue Executive Summary A No Frills Distillation of Vendor’s Marketing Collateral Thomas A Ference President & CEO Human Resources Mining & Distribution Co Locating, Validating and Accelerating HR  Innovation   Office: 219-662-0201 Cell: 630-240-2583 Fax: 219-661-0236 e-mail: tference@hrmdco.com Website: www.hrmdco.com

Contingent Fee Rx Audit & Plan Asset Recovery All Rx audit services vendors focus on identifying anomalies and overpayments related to areas such as contract adherence on discount guarantees, mis- categorization of drugs, benchmark unit pricing, etc. However, once the errors are identified, these vendors fail to recoup the funds / ERISA plan assets as required by law. This service provider offers a free-upfront audit of the last 12 months’ worth of Rx claims in order to assess the potential opportunity. Takes only two to three weeks to get results from first 12 months audit

Contingent Fee Rx Audit & Plan Asset Recovery If the client desires, thereafter the vendor will audit the remaining open years and retain a percent of savings contingency fee. Minimal HR staff time required if auditor provided with a PBM authorization letter allowing auditor to access the Rx claims file  Conservatively, the program recovers between 2-4% of the total pharmacy spend conducted over a 2 to 3 year retrospective audit of 100% of paid pharmacy claims. An optional PEPM-based on-going monitoring and pricing concession service typically produces between a 5% and 10% additional savings

Sample Savings Per 1000 Employees Item Number Number of Employees 1000 Number of Total Plan Members 2400 Annual Rx Spend per Member $1,000 Annual Rx Spend Total $2,400,000 (2400 X $1,000) Assumed Savings Rate +3% of Spend $72,000 (one year) Savings Over 3 Years $216,000 Sales Equivalent at 10% Margin Rate $2,160,000 ($216,000 / 10%)

Next Steps This product/service is contained in the HR Specialty Products & Services Catalogue™ Operational level details about this particular service provider can be obtained in conference with the vendor The HR Mining &Distribution Co. is an independent and contracted representative of the vendor Upon your request, we will arrange for an introduction that can range from a simple, quick conference call to a services overview / system demo Tom Ference 219-662-0201 (Chicagoland area) or tference@hrmdco.com Thank you for your potential interest in this fresh thinking