Most pharmacies know some claims lose money. Very few can say which drugs, which payers, or how much per year. I reconcile your remittances against acquisition cost line by line and produce the number: reimbursement below acquisition cost by NDC and by payer, your effective rate against the contracted rate, dispensing fee erosion, price concessions and adjustments, and profitability by payer and by medication category. The output is a list of prescriptions you are losing money to fill and what that costs annually which is the fact you need before any contract conversation, any purchasing change, or any decision about whether a network is worth staying in.

What the analysis covers

• Reimbursement versus acquisition cost by NDC
• Effective rate reconciliation against contracted terms
• Ingredient cost and dispensing fee analysis
• Price concession and claim adjustment tracking
• Below-cost reimbursement identification, ranked by annual dollar impact
• Prescription profitability by payer and by medication category
• Specialty drug reimbursement analysis
• Payment timing and cash conversion
• Payer mix analysis and network performance
• Contract term financial modeling and renewal decision support
• Appeal and dispute document organization