ClaimGuard was built to monitor generic and brand-name prescription claims for under-reimbursement. Driven by data analytics and appeals logic, this robust solution allows the ClaimGuard team to proactively identify and analyze prescription claims that have been paid below cost.
Our process supports compliance with state and federal law. Our team automatically submits underpaid claims for appeal to pharmacy benefit managers (PBMs) on your behalf. We receive PBM responses and communicate important details to your pharmacy so you can take action—including reversing and rebilling to improve your reimbursement.