Get claims-level visibility with PCM.

Monitor, enrich, and store plan data all in one data support platform. Plus, get actionable pharmacy and medical insights to validate plan costs.

WHY PCM?

Claims-level plan and BOB detail at your fingertips. Organized to optimize benefit management, so you can see cost drivers, utilization, and engagement in a click.

Support Solutions

Data Enrichment
Pharmacy Analytics
Medical Insights
File Management

Rx Analytics

You don’t need more pharmacy claims data, you need better data intelligence. PCM provides cost-containment through deeper claims visibility, including actionable insights into:

Plan Eligibility
Low-Value Drugs
DAW Review
Fraud, Waste, and Abuse
Clinical Review

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Claims-Level Plan Management

PCM’s data support platform simplifies plan management by putting data to work. Load your plan data, and our automated system does the rest: no more spreadsheets, no more tedious analysis, just streamlined, transparent plan data.

Aggregate

View data across vendors and groups for a global plan view of:

Participant utilization
Provider analysis
Drug spend

Analyze

Explore plan-specific insights to see where Rx dollars are going:

Low-Value Drugs
DAW Review
Fraud, Waste, & Abuse

Act

Manage and validate supplemental bolt-on programs:

Customer Reporting
Rx Savings
Contract Validation

Rx Analytics Built for You

Benefit Brokers

Global Data View
Report Builder
Contract Validation
Rebate Management

Plan Sponsor

Rebate Management
Prior Auth Review
Turnkey Solutions
Actionable Insights

TPAs

BOB & Detail Views
File Management
Report Builder
Contract Validation

Consultants

Report Builder
Contract Validation
Market Check
Drug Search

See how PCM simplifies Rx analytics.

Let's Talk

Medical Analytics

Aggregate diagnosis, procedure, provider, and participant data in the PCM platform for actionable medical insights into:

J Codes
Chronic Care Conditions
Percent of Medicare
Facility Utilization
Participant Spend

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Transparent Claim Detail

With PCM’s medical analytics, you can make data-driven decisions based on transparent diagnosis, procedure, provider, and hospital information. No more relying on vendor reports full of hidden fees and adjusted claims.

Validate PMPM Spend

Explore plan-specific insights to where your medical dollars are going.

Analyze Medical Pharmacy

Review J Codes and aggregated amounts for a global view of pharmacy spend

Optimize Plan Design

Build a medical plan validated with claims-level detail.

Get complete data transparency to drive global plan decisions.

Let's Talk

File Management

Track thousands of claims files, validating data integrity and managing dependencies in one platform.

Aggregate vendor data
Autoload claims and eligibility files
Securely transmit files
Warehouse group and BOB data

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Data Warehouse

Create a single source of truth for pharmacy and medical claims and eligibility files.

Multi-vendor integration
Secure storage and transmission
Single point of access
Standardized semantics
Historical data storage

File Autoloading

PCM’s secure infrastructure provides fully automated file loading so you can see where your files are and where they need to go. Schedule file transfers in and out of your data warehouse for multiple vendors all in one place.

Tracking

Tag

Store

Transmit

Streamline file management.

Let's Talk

Get claims-level visibility with PCM.

Rebate management, Rx and medical claims visibility, and file management to reduce workload and improve margins.

Why PCM analytics?

PCM provides claims-level plan and BOB detail at your fingergips. Organized to optimize benefit management so you can see cost drivers, utilizaiton, and engagement in a click.

Support Solutions

Rx Analytics
Medical Analytics
File Management

Rx Analytics

You don’t need more Rx claims data, you need better data intelligence.

PCM’s analytics platform simplifies plan management by putting data to work. Load your plan data, and our automated system does the rest: no more spreadsheets, no more tedious analysis, just streamlined, transparent plan data.