The trust's money, checked claim by claim.
You administer a Taft-Hartley or multiemployer health fund. The trustees have a duty to the members, the fund's attorney asks hard questions, and the PBM contract was negotiated years ago by people who may no longer be at the table. The fund has a right to audit it.
What we do
OwedRx re-prices every prescription claim the fund paid against the contract's terms, across pricing, rebates, service guarantees, the clinical programs the fund pays for, and eligibility, including members who had left but were still being paid for. We document what the fund was overcharged and recover it.
Published audits of other plans show what an audit finds when someone finally looks. Read them, with their sources.
What it costs
Pricing is set per engagement after the free review, based on what your contract allows.
What you get
A report the trustees can present to the membership. A recovery plan the fund's attorney can act on, sequenced to the contract's dispute window. A permanent file that documents the trustees' diligence.
How it starts
A free review of last year's claims with no notice to the PBM. About three weeks to a memo that tells the trustees what an audit would find.
Questions
Does the free review use our audit right?
No. The free review runs on data the fund already holds: the claims file your TPA or data warehouse keeps and the reports your PBM has already sent you. Nothing goes to the PBM, and the review is not run as an audit under your contract. Your right to audit stays in reserve for the formal audit, timed to the window your contract allows.
What decides the terms?
Two things: the rules for Taft-Hartley funds, and your PBM contract. Public plans, Taft-Hartley funds and employer plans follow different rules on how an auditor may be paid, and many PBM contracts add auditor terms of their own. The free review reads your contract's audit clause and tells you which rules apply. Terms are then set per engagement and written into the engagement letter. No PBM, pharmacy, manufacturer or broker pays us anything.
Will our PBM accept you as auditor?
Your contract decides, so we check it first. Many PBM contracts say how often a plan may audit, with how much notice, in which months, how far back, and who may audit; some let the PBM approve the firm or require the auditor to sign its confidentiality terms. The free review reads those clauses and tells you, with the clause cited, whether we qualify and when the earliest window opens. We do not take on an audit your contract does not let us run. When a PBM asks, we give it a statement of our independence, our method and our insurance.
What do you need from us?
To start the free review: the NDA and business associate agreement we send, signed; your PBM contract with every amendment and pricing exhibit; and last plan year's claims file, which your TPA or data warehouse already has. If they are to hand, the PBM's reconciliation reports, rebate statements and invoices, and your eligibility file help us tie the totals. No claim data goes through this website; we send a secure link. For the audit itself: one signed envelope and your approval of the letter. We request everything else and report to your inbox.
Where does our data live?
In our US cloud, under the business associate agreement you sign before any file moves. Everything the fund sends sits under its own encryption key, and no other plan's audit can reach it. Member identifiers are hashed on arrival. No one on our side has standing access to plan data; emergency access is time-limited and logged. The record of your audit is sealed where it cannot be changed, and the file is yours to keep whether or not you keep us.