Redefining Pharmacy Benefit Management

Healthclarity specializes in meeting the unique needs of small and midsize employer groups with a focus on choice and flexibility. Today’s pharmacy benefit market leaves smaller employers with little to no flexibility and they are often forced to take off the shelf products due to their size.

As a client of Healthclarity you will have the freedom to personalize your pharmacy benefit plan to create maximum value for each dollar you spend. Healthclarity believes in doing business in an honest and transparent way, and we strive to give our clients complete access and control of their pharmacy benefits.

  • Your Personalized Pharmacy Benefit Includes:

  • A nationwide pharmacy network with over 65,000 pharmacies and the ability to customize local preferred networks for better pricing

  • 90 day at retail network

  • Access to a comprehensive mail order and specialty fulfillment program

  • Competitive pricing and rebates

  • Member web portal – Utilizing our web portal, members can access information from our online system and view member specific information.

  • 24/7/365 member services

  • Choice and flexibility in your formulary and benefit design

  • Detailed quarterly reporting and plan design recommendations

Free Prescription Claims Audit

Healthclarity offers prospective clients the opportunity to receive a free claims audit for up to 2 years of historical pharmacy claims.  This analysis allows clients to assess their current pharmacy benefit manager’s performance and compliance with contract terms, guarantees and pricing.  Along with our analysis, we will show you how you could have saved with Healthclarity as your pharmacy benefits partner.

Pharmacy benefits management is a complicated topic and it can be difficult for companies to understand if their pharmacy benefit manager (PBM) is honoring their contractual guarantees.  In the process of implementing new clients we often discover that our clients have been overpaying their previous PBMs or that the PBM was not honoring the terms of their contract.  Healthclarity believes in doing business in an honest and transparent way, and we strive to give our clients complete access and control of their pharmacy benefits.

For that reason, Healthclarity offers prospective clients the opportunity to receive a free claims audit for up to 2 years of historical pharmacy claims.  This analysis allows clients to assess their current pharmacy benefit manager’s performance and compliance with contract terms, guarantees and pricing.  Along with our analysis, we will show you how you could have saved with Healthclarity as your pharmacy benefits partner.

How it Works:

  1. Once you have decided to utilize our free audit, our sales team will work with you to assemble the necessary claims information. The list of claims elements on page 2 can be used to request the necessary claims data from your current PBM.

  2. Once the claims files have been submitted to Healthclarity via a secure, HIPAA protected method, our analytics team will go to work.

  3. We will issue a comprehensive audit report highlighting:

    1. Historical claims performance across each distribution channel (retail 30/90, mail order, specialty, in-house pharmacies – as applicable)

    2. Discount and rebate performance versus the contract guarantee.

    3. Overcharges and compliance gaps

    4. Discount and rebate shortfalls

  4. The audit report will also provide you with comparisons and savings opportunities available through Healthclarity’s programs.

  5. For qualified clients, we will also issue a report showing the extra savings your group stands to redeem as a result of a shared savings model applying 340B, GPO or WAC pricing as permissible.

  6. Our sales and clinical teams will meet with you to review our findings and determine next steps.

What We Do

Healthclarity uses a disintermediation approach to redesigning the Rx supply chain. We use a pharmacy driven, supply side  PBM model. This model returns clinical and economic control to pharmacies removing the need for traditional mechanisms in facilitating access to prescription drugs and pharmacy services.

Who We Are

Healthclarity specializes in helping hospital, health system and independent pharmacies redesign the Rx supply chain.  We are a pharmacy care services firm solely focused on the financing, reimbursement and delivery of Rx and pharmacy services. We provide service to a wide array of pharmacy operators ranging from hospitals and health systems to
independents and  provider-directed service networks.

Ryan Paul Liabenow

Ryan Paul is the founder and CEO of Healthclarity. He brings over 15 years of executive experience having led national provider and payer organizations. Ryan Paul brings a diverse background in managed care and is now working to pave the way for a ‘new generation’ approach to drug management.