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'InvoiceCHECK' Cuts Prescription Benefit Waste

Unique Product from TRICAST Eliminates Annual Audits & Contentious Audit

Recovery Attempts; Provides Ongoing Compliance

MILWAUKEE, Dec. 5 /PRNewswire/ -- InvoiceCHECK, an innovative forensic prescription claims audit designed to verify PBM claims billings for each invoice, has been introduced by TRICAST.

InvoiceCHECK replaces annual retrospective audits by auditing claims each time a company receives an invoice for its prescription benefit claims.

"Every time that an employer receives a bill, we run the claims on the invoice through our system to make sure the invoice is correct and the client has been properly billed," said Greg Rucinski, TRICAST President. "If there are any discrepancies in your contract pricing or your plan design, we find them every two weeks instead of letting them pile up over a year and then doing a big, retrospective audit."

This exciting new product uses TRICAST analytics and proprietary software applications to deliver significant value to employers who sponsor pharmacy benefits, including:

-- a basis for sarbanes oxley compliance and fiduciary accountability

-- no more annual retrospective audits

-- no more potentially contentious audit recovery attempts

-- on-going compliance with contract pricing and plan design

-- up-to-date and immediate financial reporting

"Think of it as preventive maintenance, like changing your oil every 3,000 miles," said John Adler, TRICAST National Practice Leader. "It costs about $20 to change your oil. What happens if you don't? Your engine is ruined."

"InvoiceCHECK provides a 'sentinel effect' to assure you that billing discrepancies are caught and corrected before they grow into a lot of money," Adler said. "Conversely, waiting to do an annual, retrospective audit often leads to a cumbersome, time-consuming, contentious process that identifies errors but does not result in total recovery of the identified dollars. If a plan sponsor still needs an annual audit, InvoiceCHECK is cumulative, so it also fills this need."

"InvoiceCHECK provides verification that your PBM is paying claims according to your contract pricing and plan design," added Rucinski. "This product is designed as a basis for communication in lieu of litigation. It is much easier to fix problems when they are a few weeks old."

"When we engage a client for on-going management, we typically identify 5-7% of waste in annual pharmacy benefit dollars," said Adler. "We think that InvoiceCHECK is a natural starting point to find process improvement opportunities and eliminate cost in-efficiencies."


TRICAST, founded in Milwaukee in 1997, uses Rx and medical claims analysis to find, fix, and forecast risk in a variety of environments for self-funded employers, health plans, insurance companies, and Taft Hartley Funds. The company also provides a platform for ROI decision support and the communication strategies necessary to successfully implement them. The net result is lower annual trend and improved risk management.

TRICAST delivers data-driven cost control solutions every day and offers programs, products, and applications for pharmacy benefits that assist in controlling overall healthcare costs.

For business inquiries only, please contact John Adler, National Practice Leaderat 414.302.9733 or visit Media inquiries should be directed to Michael Beightol, Coyote Marsh & Associates, Inc., 847.277.7353.

SOURCE Tricast, Inc.
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