Analytics

Claims visibility, plan-specific insights, and comprehensive reporting reduce workload and improve margins

Analytics page header

Analytics

Claims visibility, plan-specific insights, and comprehensive reporting reduce workload and improve margins

Analytics page header

Rebate Management

3

As advertised, drug rebates should provide savings on high-cost drugs, but they may be driving up costs, resulting in:

  • An inflexible, closed formulary
  • Opaque lowest net-cost metrics
  • Inaccessible pricing details
  • Automated prior-auth processes
  • Limited cost-containment integrations
TPA Scalable Client Management

Create Client-Specific Formularies

Build a formulary based on lowest net-cost, not misaligned incentives.

Analytics Rebate Plan

Plan flexibility to control formulary changes, manage prior-auth protocols, and improve clinical outcomes.

Analytics Rebate Comprehensive Report

Comprehensive reporting to indentify drug-level trends for easier deployment of lowest net-cost strategies.

TPA Comprehensive Plan Reporting

Optimize Rebates

Analyze your existing claims data to identify plan rebates and highlight true net-cost at the drug level.

 

  • Easy cost-containment integrations
  • In-depth drug level reporting
  • Improved clinical outcomes

Improve plan efficiency and optimize rebates with PCM.

Pharmacy Analytics

3

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

  • Eligibility Review
  • Low-Value Drugs
  • DAW Review
  • Fraud, Waste, and Abuse
  • Clinical Review
image 46 1
Partner Home Broker

Benefit Brokers

  • Global data view
  • Dynamic report builder
  • Contract validation
  • Rebate Management
Partners Page Plan Sponsor 1

Plan Sponsor

  • Rebate Management
  • Prior auth review
  • Turnkey programs
  • Actionable plan insights
image 80

TPAs

  • BOB summary & detail view
  • Automated file management
  • Dynamic report builder
  • Contract validation
Partners Home Consultant 1

Consultants

  • Dynamic report builder
  • Cost containment insights
  • Contract performance review
  • Easy drug search

See how PCM simplifies pharmacy benefit management.

Medical Analytics

3

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

  • J Codes
  • Chronic Care Conditions
  • Percent of Medicare
  • Facility Utilization
  • Participant Spend
Screenshot of PCM analytics platform.

Transparent Claim Detail

With PCM’s Medical Analytics, plans can make data-driven decisions.

Analytics Med Ana Validate PMPM Spend

Validate PMPM Spend

Explore plan-specific insights to see where pharmacy dollars are going.

Analytics Med Ana Analyze medical pharmacy

Analyze Medical Pharmacy

Review J Codes and aggregated spend for a global view.

Analytics Med Ana Optimize plan design

Optimize Plan Design

Build a medical plan validated with claims-level detail.

image 47

Get complete data transparency to drive global plan decisions.

File Management

3

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

  • Aggregate vendor data
  • Manage claims and eligibility files

  • Securely transmit files

  • Scale for group or BOB

image 44

Data Warehouse

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

  • 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:

Analytics File Management Tracking

Tracking

Analytics File Management Tagging

Tagging

Analytics File Management Storage

Storage

Analytics File Management Transmission

Transmission

image 48

More efficiently track, tag, sort, and transmit data.

Rebate Management

As advertised, drug rebates should provide savings on high-cost drugs, but they may be driving up costs.

Create Client-Specific Formulary

Build a formulary based on lowest net-cost, not misaligned incentives.

Analytics Rebate Plan

Plan flexibility to control formulary changes, manage prior-auth protocols, and improve clinical outcomes.

Analytics Rebate Comprehensive Report

Comprehensive reporting to indentify drug-level trends for easier deployment of lowest net-cost strategies.

Optimize Rebates

Analyze your existing claims data to identify plan rebates and highlight true net-cost at the drug level.

  • Program integrations
  • In-depth drug level reporting
  • Improved clincial outcomes

Pharmacy Analytics

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

Partner Home Broker

Benefit Brokers

  • Global data view
  • Dynamic report builder
  • Contract Validation
  • Rebate management
Partners Page Plan Sponsor 1

Plan Sponsor

  • Rebate Management
  • Prior auth review
  • Turnkey programs
  • Actioanble plan insights
image 80

TPA

  • BOB summary & detail view
  • Automated file management
  • Dynamic report builder
  • Contract validation
Partners Home Consultant 1

Consultants

  • Dynamic report builder
  • Cost containment insights
  • Contract performance
  • Easy drug search

If your claims could talk, what would they say?

Medical Analytics

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

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

Transparent Claim Detail

With PCM’s Medical Analytics, plans can make data-driven decisions.

Analytics Med Ana Validate PMPM Spend

Validate PMPM Spend

Explore plan-specific insights to see where pharmacy dollars are going. 

Analytics Med Ana Analyze medical pharmacy

Analyze Medical Pharmacy

Review J Codes and aggregated spend for a global view.

Analytics Med Ana Optimize plan design

Optimize Plan Design

Build a medical plan validated with claims-level detail. 

If your claims could talk, what would they say?

File Management

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

  • Aggregate vendor data
  • Manage claims and eligibility files

  • Securely transmit files

  • Scale for group or BOB

Data Warehouse

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

  • Multi-vendor integration
  • Secure storage and transmission
  • Single point of access
  • Standardized semantics
  • Historical data storage
TPA Comprehensive Plan Reporting

File Autoloading

PCM’s secure infrastructure provides fully auotmated file management.

Analytics File Management Tracking

File Tracking

Analytics File Management Tagging

File Tagging

Analytics File Management Storage

File Storage

See how PCM supports you.

Ready to learn more?

PCM provides the visibility, insights, and tools you need. Want proof? Click here to schedule a demo.

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