Decades of experience ensuring claim submission compliance in the PBM, pharmacy, and claims processing industry.
Our analytics engine and audit workflow processes allow clients to find and fix issues before they evlove into potential fraud, waste, and abuse recoveries.
We are not a blackbox that is set and you do not what is happening. Clients have full control of setting paramaters to find and fix discrepant claim submissions.
HBT has been assisting Pharmacy Benefit Managers, Claims Processors, and Health Plans audit pharmacy claims since 2008. Conceived from spredsheets and a desire to improve document tracking the ClaimWiseRx claim auditing platform was born. ClaimWiseRx has facilitated the improved oversight of submitted claims within client pharmacy networks to ensure those claims meet health plan, federal and state requirements. Headquartered in Parker, Colorado HBT's team consists of senior level managed care professionals, experienced accredited auditors, and a healthcare compliance officer who have worked at health plans, PBMs, and pharmacies. Being centrally located in the United States enables us to serve our clients in an timely and effective manner. Our platform, expertise, and background uniquely positions us in the design of user friendly, pharmacy friendly, efficient and comprehensive auditing solutions for the industry.
Our focus is primarily medium to small PBMs, managers of pharmacy networks, and includes commerical, Medicare, and Medicaid lines of business within retail, mail order, specialty, and long term care pharmacies.
It is a formidable proposition to meet fiduciary responsibility and proactively manage costs. HBT provides an independent state of the art claim auditing system and professional services tailored to meet the specific and ever-evolving auditing needs facing our clients.
SAS Solution - Work from anywhere. Broad library of edits. Automated notices. Simplified yet quick, accurate, repeatable process. Integrated desktop and on-site audit solution.
Enables clients to fully administer and manage their auditing program by utilizing the ClaimWiseRx system via the internet hosted on HBT controlled servers.
Provides clients with full service auditing services performed by HBT staff.
In addtion to offering On-Site Audit servcies for FOCUS or RESOLVE clients, HBT may peform stand alone On-Site Audits on a clients behalf.
Our auditors have over 20 years of designing effective edits finding discrepant claims.
Compare your data with our edits. Let's see your results.
Encompasses ClaimWiseRx training, system configuration and edit support, additional or back up staffing, onsite or investigation audits, and custom development.