Automated Claims

We’re here to streamline compliance management, ensuring your next audit or appeal with unwavering confidence and peace of mind.

Here at PHG, we have implemented an automated claims file analytics process that is instrumental in optimizing strategy and rebate yield for clients and achieving substantial savings for clients. By harnessing advanced analytics tools, PHG gains the ability to swiftly analyze vast amount of claims data, identifying patterns, trends and opportunities that might otherwise go unnoticed. This data-driven approach enables PHG to tailor formulary strategies more precisely, ensuring that clients can maximize cost savings without compromising quality. Additionally, the automated process facilities efficient rebate aggregation, streamlining negotiations with manufacturers and vendors. The real-time insights derived from analytics empower PHG to make informed decisions, ad proactively adjust formulary strategies. Overall, our sophisticated analytics framework not only enhances operatio9nal efficiency by also contributes significantly to achieving optimal financial outcomes for clients, fostering a dynamic and responsive approach to formulary management.

Your Compliance Partner

Why Compliance Matters

Program management optimization required demands precision and a steadfast commitment to compliance. Compliance and internal audits are integral to this process, and having a trusted partner by your side can make all the difference.

Claims and Review Submission

We recognize that managing 340B compliance is not a one-time effort; it’s an ongoing commitment. Here’s how PHG can be your ally in this journey:

Maximize Savings

Peak Compliance

Optimize Performance

Audit & Appeals

We’re dedicated to helping you maximize your 340B program savings. Our expertise ensures that you’re making the most of this valuable program, enabling you to reinvest in patient care.

Maintaining peak compliance is essential. Our comprehensive compliance management solutions are designed to keep you on track, ensuring you meet all HRSA requirements and guidelines.

Contract pharmacies play a pivotal role in the 340B program. We work with you to optimize their performance, enhancing their ability to serve your organization and community effectively.

In the event of an audit dispute or appeal, we provide the support you need. Our experts can guide you through the appeals process, helping you navigate challenges and achieve the best possible outcome.

340b Compliance

340B Optimization: Robust validation algorithm ensuring a consistent and appropriate classification of 340B claims at the pharmacy level. Ensures client value is not inappropriately scrubbed.

Financial Forecasting: Proprietary deep engine forecasting model allows us to apply a forecasted financial value at the claim level and to track that value through the entire claim lifecycle.

Underwriting & Pricing: Nimble and detailed pricing models outlining key drivers in performance expectations. Best in class turnaround times in order to exceed aggressive market deadlines.

At PHG, we are committed to our clients success. Our goal is to make management of your program faster and more efficient, allowing you to focus on what truly matters – providing exceptional service to your customers.