Pharmacy Benefit Forensics Successfully Identifies Another FWA Pharmacy, Receives Restitution

Once again. our preventative services have proactively identified a suspicious pharmacy submitting claims for drugs we previously identified as "red flags". Our proprietary software used data from other identified bad actors and highlighted a small pharmacy in Red Bank, New Jersey submitting similar prescription claims to our employer. The employer PBM was directed to immediately stop paying claims to this pharmacy as a result of Pharmacy Benefit Forensics detailed follow up investigation. Previously paid claim dollars were returned to our employer while the rogue pharmacy continued to generate $millions in the same "red flag" drug claims to other employers. This past week, we discovered that one of the Nations largest PBM's had issued a demand letter to the pharmacy to repay their clients over $12 MILLION. Unfortunately, the pharmacy owner was found to be long gone and had closed the store and locked the doors just a few weeks prior. Find out how Pharmacy Benefit Forensics can protect your valuable benefit dollars at no upfront cost today.