OwedRx

AI that audits your pharmacy benefit contract. Every claim. Free to find out.

OwedRx reads your PBM contract, re-prices every prescription claim your plan paid against it, and finds what you were overcharged: pricing, rebates, service guarantees, programs you paid for that never ran, and people who had left but were still covered. You see the number before you decide anything.

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Demonstration on synthetic data

Contract

  • 3,100 employees
  • Calendar-year contract
  • 14 pricing terms extracted

Claims checked

400,000 of 400,000

Findings

$469,400 found. $427,000 recoverable.

Six findings checked. Five go to the PBM. One dropped: a contract amendment answers it.

How it works

  1. The AI reads your contract and turns every term into a rule with its clause.
  2. Software re-prices every claim under those rules; no sampling, no model deciding a dollar.
  3. A pharmacist signs the findings and the PBM's likely objections are answered before you see them.
  4. You get the report, the recovery plan, and the money.

The review is free and uses data you already have. If it finds money, the audit recovers it, under terms your contract allows. See pricing.

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You do four things. We do the rest.

  1. Say yes and sign one envelope.
  2. Approve the letter.
  3. Answer one question if two readings of a clause are both defensible.
  4. Forward the renewal offer when it comes.

Everything else, from pulling the claims file to reconciling the credit, is done for you and reported to your inbox.

Ask anything about your audit.

Ask OwedRx

Demonstration on synthetic data

  1. YouWhy is the mail finding $62,100?

    Ask OwedRx

    Clause 4.3 sets a price guarantee for generic drugs filled by mail, and defines a mail claim as one with 84 days' supply or more. 1,184 of those claims were paid above the guarantee for the day they were filled, by $62,100 in total.

    Cites: Clause 4.3 · Exhibit B · 1,184 claims

  2. YouWhat will the PBM say?

    Ask OwedRx

    Most likely that the guarantee is measured across the whole year, not claim by claim. Clause 4.3 prices each claim, and the year-end reconciliation in clause 4.8 does not override it. The letter answers that before they raise it.

    Cites: Clause 4.3 · Clause 4.8

  3. YouCan I show this to the board?

    Ask OwedRx

    Yes. The board summary is page 2 of the report: each finding in one line with its clause, and nothing that identifies a member.

    Cites: Report, page 2

    Your counsel and your broker can ask too. Every answer cites the clause and the claim.

    Find out what your PBM owes you.

    Ask about a free review